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Old page wikitext, before the edit (old_wikitext) | '{{Short description|British serial killer (born 1990)}}
{{Use British English|date=August 2023}}
{{Use dmy dates|date=August 2023}}
{{Primary sources|date=November 2023}}
{{Infobox criminal
| name = Lucy Letby
| occupation = Neonatal nurse
| image = Lucy Letby mugshot.jpg
| caption = Letby following her arrest in 2018
| birth_date = {{Birth date and age|1990|01|04|df=yes}}
| birth_place = [[Hereford]], [[Herefordshire]], England
| country = United Kingdom
| beginyear = 2015
| endyear = 2016
| apprehended = 3 July 2018
| conviction = [[Murder in English law|Murder]] (7 counts), [[attempted murder]] (7 counts)
| charge = Attempted murder (1 count; to go to trial in 2024)
| fatalities = 7
| injuries = 6
| penalty = {{Br separated entries|[[Life imprisonment in England and Wales|Life imprisonment]]|([[whole life order]])}}
| imprisoned = [[HM Prison Bronzefield]] {{asof|January 2024|lc=y}}
}}
'''Lucy Letby''' (born 4 January 1990) is a British former [[neonatal nurse]] who was convicted of murdering seven infants and attempting to murder six others between June 2015 and June 2016. Letby was the focus of suspicion following a high number of [[infant death]]s at the [[neonatal intensive care unit|neonatal unit]] of the [[Countess of Chester Hospital]], shortly after she was qualified to work with children in the hospital's [[intensive care unit]], and owing to her being on duty whenever suspicious incidents took place.
Letby was charged in November 2020 with eight counts of murder and ten counts of [[attempted murder]]. During her trial, which lasted from October 2022 to August 2023, it was revealed that Letby's accused methods included injecting the infants [[air embolism|with air]] or insulin, overfeeding them, and physically abusing them with medical tools. She also removed over 250 confidential nursing handover sheets from her workplace which should never have left the hospital, and she falsified patient records to avert suspicion. Several parents and colleagues of Letby had also entered the room during, or soon after, an attack. On 21 August 2023, Letby was sentenced to [[Life imprisonment in England and Wales|life imprisonment]] with a [[whole life order]]. Letby had pleaded not guilty at her trial and told a subsequent [[Nursing and Midwifery Council]] disciplinary panel that she is innocent. An application to appeal her conviction was renewed in February 2024 and was heard by the [[Court of Appeal (England and Wales)|Court of Appeal]] in April 2024 with judgement reserved to a later date. She also faces a retrial in June 2024 on the single charge on which the jury were unable to reach a verdict in the original trial.
Letby is the most prolific serial killer of children in modern British history; the [[Cheshire Constabulary]] now suspects that she may have claimed more victims, including at [[Liverpool Women's Hospital]], where two infants died during her training. Management at the Countess of Chester Hospital were criticised for ignoring warnings about Letby that could have prevented some of the killings. The [[Government of the United Kingdom|British government]] has commissioned an independent statutory inquiry into the circumstances surrounding the murders.
==Early life and education==
Lucy Letby was born on 4 January 1990 in [[Hereford]], [[Herefordshire]], the only child of a finance manager and an accounts clerk.<ref name=":1">{{Cite news |last1=Ball |first1=Tom |last2=Mitib |first2=Ali |last3=Wace |first3=Charlotte |date=18 August 2023 |title=Who is Lucy Letby? The nurse who became Britain's most prolific child killer |work=The Times |url=https://www.thetimes.co.uk/article/who-is-lucy-letby-nurse-killed-family-babies-background-family-friends-education-s7njrswmc |url-access=subscription |access-date=19 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820205750/https://www.thetimes.co.uk/article/who-is-lucy-letby-nurse-killed-family-babies-background-family-friends-education-s7njrswmc |url-status=live }}</ref> She was educated at [[Aylestone School]] and [[Hereford Sixth Form College]].<ref name=":1" /><ref name="bbc20230818">{{Cite AV media |url=https://www.bbc.co.uk/news/uk-england-merseyside-65058159 |title=Who is baby serial killer Lucy Letby? |date=18 August 2023 |last=Hirst |first=Lauren |access-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818124114/https://www.bbc.co.uk/news/uk-england-merseyside-65058159 |archive-date=18 August 2023 |url-status=live |work=BBC News}}</ref> She had had a very difficult birth herself and was, according to a friend who knew her since secondary school, "very grateful for being alive to the nurses who would have helped save her life".{{R|Panorama|at=18:40}} This, the friend states, had led her to want to be a nurse all her life and that "everything that she did was geared towards that ultimate goal of becoming a nurse".{{R|Panorama|at=18:55}}<ref name="bbc2">{{Cite news |last=Moritz |first=Judith |date=18 August 2023 |title=What I learned about Lucy Letby after 10 months in court |work=BBC News |url=https://www.bbc.com/news/uk-66104004 |access-date=21 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824083632/https://www.bbc.com/news/uk-66104004 |url-status=live }}</ref> Letby pursued her education in nursing at the [[University of Chester]], where she also worked as a student nurse during her three years of training, carrying out placements at [[Liverpool Women's Hospital]] and the [[Countess of Chester Hospital]].<ref name=":1" /><ref name="moreau">{{Cite news |last=Moreau |first=Charlotte |date=19 August 2023 |title=Hereford 'very much home' for serial killer Lucy Letby |work=Hereford Times |url=https://www.herefordtimes.com/news/23733719.hereford-very-much-home-serial-killer-lucy-letby/ |access-date=19 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820185736/https://www.herefordtimes.com/news/23733719.hereford-very-much-home-serial-killer-lucy-letby/ |url-status=live }}</ref> Letby was the first member of her family to study at university and graduated in September 2011.<ref name=":1" />
==Career==
Letby began working as a [[registered nurse]] at the neonatal unit of the Countess of Chester Hospital in 2012.<ref name=Lintern>{{cite news|url=https://www.thetimes.co.uk/article/lucy-letby-files-nurse-hospital-evidence-rkxchgqh9|url-access=subscription|work=The Times |date=19 August 2023|last1=Lintern|first1=Shaun|last2=Collins|first2=David|title=Revealed: the files that show how Lucy Letby was treated as a victim|access-date=19 August 2023|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820190349/https://www.thetimes.co.uk/article/lucy-letby-files-nurse-hospital-evidence-rkxchgqh9|url-status=live}}</ref> In a 2013 staff profile, she said that she was responsible for "caring for a wide range of babies requiring various levels of support" and that she enjoyed "seeing them progress and supporting their families."<ref>{{cite web |date=28 March 2013 |title=Staff Profile – Lucy Letby |url=https://www.coch.nhs.uk/media/74654/chester_standard_babygrow_page_1070kb__28.03.2013_.pdf |access-date=18 August 2023 |archive-date=5 December 2022 |archive-url=https://web.archive.org/web/20221205060026/https://www.coch.nhs.uk/media/74654/chester_standard_babygrow_page_1070kb__28.03.2013_.pdf |url-status=live}}</ref> Letby also took part in a campaign to raise funds for a new neonatal unit at the hospital.<ref name=":0">{{cite news|title=Home searched after baby murder arrest belongs to Chester children's nurse |url=https://www.chesterstandard.co.uk/news/16332233.home-searched-baby-murder-arrest-belongs-chester-childrens-nurse/ |access-date=27 October 2022 |work=The Standard |date=4 July 2018 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027192329/https://www.chesterstandard.co.uk/news/16332233.home-searched-baby-murder-arrest-belongs-chester-childrens-nurse/ |url-status=live }}</ref>
Letby had two training placements at Liverpool Women's Hospital, in late 2012 and early 2015, which came under investigation after her conviction.<ref name="moreau" /> In June 2016, consultants asked management to remove her from clinical duties pending an investigation into her conduct. She had previously been moved from night to day shifts in April 2016 by the unit's ward manager.<ref name="Lintern" /> Letby was transferred to the patient experience team in July 2016 and later to the risk and patient safety office, working there until her arrest in 2018.<ref name="HSJ" />
Letby qualified to work with the infants who needed intensive care in 2015, the same year the suspicious incidents began.<ref name="Intensive2015">{{cite news |last1=Corcoran |first1=Sophie |title=What is the evidence against Lucy Letby? Five key points that convicted baby killer |url=https://www.examinerlive.co.uk/news/uk-world-news/what-evidence-against-lucy-letby-27549159 |access-date=25 August 2023 |work=YorkshireLive |date=18 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824141723/https://www.examinerlive.co.uk/news/uk-world-news/what-evidence-against-lucy-letby-27549159 |url-status=live }}</ref> Letby had told others that she found non-intensive care work "boring".<ref name="boring" /> When she was moved to day shifts the suspicious incidents notably moved from occurring overnight to happening in the daytime when Letby was working.<ref name="CPS"/>
==Murders==
===Initial investigation===
An informal review conducted in June 2015 by a consultant and lead [[neonatologist]] at the Countess of Chester Hospital NHS Foundation Trust revealed troubling details regarding four unexplained collapses that occurred in the same unit. Three of these cases resulted in deaths in the same month. It was observed that Letby had been on shift on each occasion. The unit's consultants promptly reported these deaths to the trust's committee responsible for addressing serious incidents. The committee classified the deaths as "medication errors". Had they been classified as "serious incident[s] involving unexpected deaths", an immediate investigation could have taken place if they were grouped together.<ref name=Lintern/> The numbers of unexplained collapses were particularly abnormal: there had previously been only two or three deaths a year in the neonatal unit. What was also particularly unusual was that the babies did not respond to resuscitation attempts as they would be expected to.{{R|Panorama|at=23:40}} Usually babies that had got a heartbeat back would see an improvement in their breathing, but that did not happen in these cases.{{R|Panorama|at=23:45}} Detective Superintendent Paul Hughes, who later led the investigation,<ref name=Trust/> was told by two medical consultants that baby collapses which occurred during the spike had been unexpected and could not be explained, both of which were not usual with infant collapses in general.<ref name="skynews_202308"/>
In October 2015, a ward manager conducted her own review, noting that Letby was the only staff member consistently present throughout these incidents of unexplained collapses and deaths. These findings were relayed to the lead neonatologist. Further concerns were voiced to management by the unit's consultants that same month; concerns were either resisted by the Trust Executives or ignored.<ref name="HSJ" /><ref name=":3" /> In February 2016, the lead neonatologist, along with other consultants, concluded a thematic review investigating five unexplained deaths and collapses within the unit. Their investigation determined that the only common factor in these cases was the presence of Letby. The lead neonatologist contacted the unit manager, the hospital's medical director and the director of nursing, requesting an urgent meeting.<ref name=":3"/> A meeting took place in May 2016.<ref name=":4" /> The executive team deemed the spike in deaths to be coincidental and no substantial action was taken.<ref name="Lintern" /><ref name=":4">{{cite news|url=https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised|work=The Guardian|title=Timeline of Lucy Letby's attacks on babies and when alarm was raised|date=18 August 2023|accessdate=20 August 2023|last1=Halliday|first1=Josh|last2=Blight|first2=Garry|last3=Fischer|first3=Harry|last4=Kirk|first4=Ashley|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820175554/https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised|url-status=live}}</ref>
Reports by the nationwide [[MBRRACE-UK]] project found a neonatal death rate at least 10% higher than expected between June 2015 and June 2016. Additionally, the neonatal death total in 2015 doubled that of the previous year.<ref>{{cite news|url=http://www.chesterchronicle.co.uk/news/chester-cheshire-news/death-rate-countess-chester-maternity-13227719|title=Death rate at Countess of Chester maternity unit among highest in country|first=Bill|last=Gleeson|date=25 June 2017 |work=CheshireLive |access-date=27 January 2023|archive-date=12 September 2018|archive-url=https://web.archive.org/web/20180912220133/https://www.chesterchronicle.co.uk/news/chester-cheshire-news/death-rate-countess-chester-maternity-13227719|url-status=live}}</ref><ref>{{Cite news|url=https://www.bbc.com/news/uk-england-merseyside-44696813|title=Countess of Chester Hospital: Woman held in baby deaths probe|date=3 July 2018|access-date=27 January 2023 |work=BBC News |archive-date=30 January 2023|archive-url=https://web.archive.org/web/20230130022933/https://www.bbc.com/news/uk-england-merseyside-44696813|url-status=live}}</ref><ref>{{cite news |last1=Matthews-King |first1=Alex |title=Lucy Letby: Newborn deaths doubled at hospital where nurse arrested on suspicion of babies' murders worked |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-baby-murders-newborn-death-rate-name-of-hospital-neo-natal-unit-police-a8433011.html |access-date=20 August 2023 |work=Independent |date=5 July 2018 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820181219/https://www.independent.co.uk/news/uk/crime/lucy-letby-baby-murders-newborn-death-rate-name-of-hospital-neo-natal-unit-police-a8433011.html |url-status=live }}</ref> The mortality rate had risen above what might be considered 'normal' rates.<ref name="Sky evidence" /> During a hospital visit in February 2016, The [[Care Quality Commission]] (CQC) was informed of difficulties in raising concerns with managers, but heard no mention of an elevated mortality rate. The CQC's report identified issues of "short-staffing" and "skill-mix" issues within the unit, yet it praised the overall positive culture of the trust, where "[s]taff felt well supported, able to raise concerns and develop professionally."<ref name="HSJ">{{cite news|url=https://www.hsj.co.uk/countess-of-chester-hospital-nhs-foundation-trust/revealed-how-trust-execs-resisted-concerns-over-letby/7035170.article|work=Health Service Journal|last=Dunhill|first=Lawrence|date=18 August 2023|access-date=19 August 2023|title=Revealed: How trust execs resisted concerns over Letby |url-status=live |archive-url=https://web.archive.org/web/20230819123650/https://www.hsj.co.uk/countess-of-chester-hospital-nhs-foundation-trust/revealed-how-trust-execs-resisted-concerns-over-letby/7035170.article |archive-date=19 August 2023}}</ref>
On 24 June 2016, following the deaths of two triplet babies on that day and the previous day, the lead neonatologist phoned the duty executive demanding that Letby be removed from the unit. The duty executive insisted that Letby was safe to work and that she was "happy to take responsibility" if anything happened to any more babies under Letby's care.<ref name=":4" /><ref name=":3">{{cite news|url=https://www.bbc.com/news/uk-66120934|work=BBC News |title=Hospital bosses ignored months of doctors' warnings about Lucy Letby|date=18 August 2023|accessdate=22 August 2023|last1=Moritz|first1=Judith|last2=Coffey|first2=Jonathan|last3=Buchanan|first3=Michael|archive-date=24 August 2023|archive-url=https://web.archive.org/web/20230824083657/https://www.bbc.com/news/uk-66120934|url-status=live}}</ref> In late June 2016, the trust's executive directors convened to address the question whether to involve law enforcement. By this time, seven unexpected deaths had taken place within the unit. The belief among these executives was that the indications of Letby's involvement were largely circumstantial and they suspected certain doctors of embarking on a misguided "witch hunt". Moreover, they were concerned about potential harm to the Trust's reputation resulting from a police inquiry. Ultimately, they opted against engaging the police.{{R|Lintern}} The medical director and chief executive instead organised a review through the [[Royal College of Paediatrics and Child Health]] (RCPCH), which was initiated in September 2016. The unit's services were scaled back by hospital managers on 7 July 2016, cutting cot space numbers and no longer accommodating premature births before the 32-week mark.<ref name="nursingtimes_20230818">{{cite web|url=https://www.nursingtimes.net/news/children/breaking-lucy-letby-convicted-of-murdering-seven-babies-at-hospital-neonatal-unit-18-08-2023/|title=Lucy Letby convicted of murdering seven babies at hospital neonatal unit|work=[[Nursing Times]]|agency=[[PA Media|The Press Association]]|date=18 August 2023|access-date=15 March 2024}}</ref>
The trust set a narrow scope for the review that excluded investigating Letby's actions or the deaths, but instead focused on the unit's general service. The RCPCH reported their findings to the medical director and chief executive in October 2016.<ref name=Lintern/> They could not find a definitive explanation for the increase in mortality rate at the unit but found some insufficient staffing and senior cover. The report recommended a detailed case review of each death. The medical director asked neonatologist Jane Hawdon from [[Great Ormond Street Hospital]] to carry out the case reviews. Hawdon responded she could not conduct a detailed review because of lack of time but could provide a summary and did so after briefly reviewing the notes. She identified four cases that "potentially benefit from local forensic review as to circumstances, personnel etc".<ref name=Lintern/><ref name=HSJ/><ref name=parveen/> The board's chair at the time has said that he was misled about the scope of that review and its findings.<ref>{{cite news|url=https://www.bbc.co.uk/news/uk-england-merseyside-66553970|title=Lucy Letby: Hospital bosses were misled, former chair claims|work=BBC News|date=19 August 2023|access-date=19 August 2023|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820123721/https://www.bbc.co.uk/news/uk-england-merseyside-66553970|url-status=live}}</ref> Despite the thorough external independent review recommended by the RCPCH or the forensic review recommended by Hawdon, records of the hospital board meeting show the medical director telling board members that the RCPCH and Hawdon reviews concluded that the deaths in the neonatal unit were due to issues with leadership and timely intervention.<ref name=":3" />
In September 2016, Letby raised a formal grievance about her late June 2016 transfer from clinical duties to the hospital's risk and patient safety office.<ref name=":3" /> This grievance was upheld by the board in January 2017, which determined her removal had been "orchestrated by the consultants with no hard evidence". They supported her return to the neonatal unit and offered her a placement at Alder Hey Children's Hospital in [[Liverpool]] plus support to develop advanced practice or a master's degree. The medical director also commented in the report that the trust's intention was to "protect Lucy Letby from these allegations".<ref name=Lintern/><ref name=HSJ/><ref name=Halliday/> The chief executive had met with Letby and her parents on 22 December 2016 to apologise on behalf of the trust and assure them that the doctors who made the allegations would be "dealt with".<ref name=Lintern/> He later ordered the consultants to send a letter of apology to Letby, which they did in February 2017.<ref name=Halliday>{{cite news|url=https://www.theguardian.com/uk-news/2023/aug/19/doctors-were-forced-to-apologise-for-raising-alarm-over-lucy-letby-and-baby-deaths|work=The Guardian|title=Doctors were forced to apologise for raising alarm over Lucy Letby and baby deaths|date=19 August 2023|access-date=19 August 2023|last=Halliday|first=Josh|url-status=live |archive-url=https://web.archive.org/web/20230819063231/https://www.theguardian.com/uk-news/2023/aug/19/doctors-were-forced-to-apologise-for-raising-alarm-over-lucy-letby-and-baby-deaths |archive-date=19 August 2023}}</ref><ref name=Trust>{{cite news|url=https://www.theguardian.com/uk-news/2023/aug/19/trust-me-im-a-nurse-why-wasnt-lucy-letby-stopped-as-months-of-went-by|work=The Guardian|date=19 August 2023|accessdate=19 August 2023|title='Trust me, I'm a nurse': Why wasn't Lucy Letby stopped as months of murder went by?|last=Halliday|first=Josh|archive-date=21 August 2023|archive-url=https://web.archive.org/web/20230821022724/https://www.theguardian.com/uk-news/2023/aug/19/trust-me-im-a-nurse-why-wasnt-lucy-letby-stopped-as-months-of-went-by|url-status=live}}</ref>
In March 2017, consultants asked management to involve the police after receiving advice from the regional neonatal lead, who suggested further investigation was needed.<ref name=HSJ/> They then met with [[Cheshire Constabulary]] on 27 April 2017, to raise their concerns, with Letby due to return to work on 3 May 2017.<ref name=Trust/> The trust publicly announced the involvement of the police in May 2017, stating this move was to "seek assurances that enable us to rule out unnatural causes of death."<ref name=HSJ/><ref name="cochmay17">{{cite web|url=http://www.coch.nhs.uk/corporate-information/news/neonatal-update-thursday-18-may.aspx|title=Neonatal Update – Thursday 18 May|date=18 May 2017|publisher=Countess of Chester NHS Foundation Trust|website=coch.nhs.uk|access-date=5 July 2018|url-status=dead|archive-date=17 June 2017|archive-url=https://web.archive.org/web/20170617153846/http://www.coch.nhs.uk/corporate-information/news/neonatal-update-thursday-18-may.aspx}}</ref> The police's investigation was called Operation Hummingbird.<ref name="guardian_20230820"/> Senior Investigating Officer Paul Hughes later said: "the initial focus was around the hypotheses of what could have occurred: so generic hypotheses of 'it could be natural-occurring deaths', 'it could be natural-occurring collapses', 'it could be an organic reason', 'it could be a virus', and then one of the hypotheses was that, obviously, it could be inflicted harm."<ref name="Sky evidence" />
===Timeline of cases===
The first suspicious case occurred on 8 June 2015.<ref name="Sky evidence" /> At 8 pm a healthy baby boy – a twin – was being cared for in nursery 1 on the ward and the designated nurse was Letby.<ref name="Sky evidence" /><ref name="Guardian timeline">{{cite news |title=Timeline of Lucy Letby's attacks on babies and when alarm was raised |url=https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised#:~:text=Lucy%20Letby%20has%20been%20found,neonatal%20unit%20where%20she%20worked. |first1=Josh|last1=Halliday|first2=Garry|last2=Blight|first3=Harry|last3=Fischer|first4=Ashley|last4=Kirk|access-date=25 August 2023 |work=The Guardian |date=18 August 2015 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820175554/https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised#:~:text=Lucy%20Letby%20has%20been%20found,neonatal%20unit%20where%20she%20worked. |url-status=live }}</ref> The boy had been handed over to Letby after she started her night shift, with the paediatric registrar having clocked off when Letby was 30 minutes into her shift.<ref name="Sky evidence" /><ref name="Guardian timeline"/><ref name="Boy A Guardian">{{cite news |title=Death of baby in Lucy Letby case 'completely out of blue', says witness |url=https://www.theguardian.com/uk-news/2022/oct/19/death-of-baby-in-lucy-letby-case-completely-out-of-blue-says-witness |access-date=25 August 2023 |work=The Guardian |date=19 October 2022 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825133432/https://www.theguardian.com/uk-news/2022/oct/19/death-of-baby-in-lucy-letby-case-completely-out-of-blue-says-witness |url-status=live }}</ref> Twenty-six minutes later, she called a doctor with the baby's state rapidly deteriorating. The baby died half an hour later, less than 90 minutes into Letby's shift.<ref name="Sky evidence" /> The paediatric registrar later testified that when she heard about the death of the child the next day after returning to work that it was a "big surprise" and "completely out of the blue and very upsetting. [He] showed no signs of any problems throughout the day. He was handling well. I had no concerns at all for him or his twin sister".<ref name="Boy A Guardian"/> A fellow nurse said that when the baby started deteriorating she saw Letby standing over the infant's incubator and originally did not intervene. However, the nurse then did when she realised he was not recovering under Letby's care.<ref name="Boy A Guardian"/> Doctors attending the scene said that Child A developed an unusual blue and white mottling on his skin after collapsing, which they said they had never seen before.<ref name="Time-s">{{cite news |title=What did Lucy Letby do? Full timeline of how the trial unfolded |url=https://www.thetimes.co.uk/article/what-did-lucy-letby-do-nurse-trial-evidence-rb662kx07 |access-date=25 August 2023 |work=The Times |date=23 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824160804/https://www.thetimes.co.uk/article/what-did-lucy-letby-do-nurse-trial-evidence-rb662kx07 |url-status=live|url-access=subscription}}</ref> This symptom later occurred in other babies that were believed to have been intentionally injected with air.<ref name="Time-s" /> The day after Child A's death, Letby searched for his parents on [[Facebook]].<ref name="Time-s" />
About 28 hours after Child A's death, his twin sister, Child B, also collapsed and had to be resuscitated.<ref name="Guardian timeline"/> After Child A's death, the parents had spent the day with Child B in the nursery with her, but were persuaded to go and rest before the baby's sudden crash.<ref name="Time-s" /> Tests later showed loops of gas-filled bowel in the child.<ref name="Guardian timeline"/> As a result, it was later concluded that the baby had been injected with air.<ref name="Guardian timeline"/> Letby had fed the baby 25 minutes before her collapse and the child had the same unusual rash on her skin as first seen on Child A hours earlier, indicating that she had also been injected with air.<ref name="Time-s" />
A few days later, Child C, a boy in good condition, died.<ref name="Guardian timeline"/> He suddenly collapsed as soon as another nurse left the nursery.<ref name="Time-s" /> Despite not being the designated nurse for the child, Letby was witnessed standing over his monitor as his alarm sounded when the other nurse came back in.<ref name="Guardian timeline"/><ref name="Time-s" /> Letby's shift leader had already told her to focus on her designated patient and the shift leader later testified that she had to keep pulling her away from the family room as Child C died.<ref name="Time-s" /> His parents later recalled a nurse they believe was Letby brought a ventilator basket in and said, even though their child was not dead, "You've said your goodbyes, do you want me to put him in here?".<ref>{{cite news |title=Lucy Letby: Baby stopped breathing without warning, trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63406551 |access-date=25 August 2023 |work=BBC News |date=26 October 2022 |archive-date=15 June 2023 |archive-url=https://web.archive.org/web/20230615222717/https://www.bbc.co.uk/news/uk-england-merseyside-63406551 |url-status=live }}</ref>
On 22 June 2015, baby girl Child D collapsed three times in the early hours and died.<ref name="Guardian timeline"/> Those who attempted to save the child noticed the girl's skin had been discoloured.<ref name="Guardian timeline"/> A post-mortem X-ray showed a 'striking' line of gas in front of the spine, consistent with air being injected into the bloodstream.<ref name="Spine">{{cite news |title=Lucy Letby trial: Air was injected into baby's blood |url=https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |access-date=25 August 2023 |work=BBC News |date=11 November 2022 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824061847/https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |url-status=live }}</ref> A doctor later testified that such a finding could not be explained by natural causes.<ref>{{cite news |title=Lucy Letby trial: Unusual finding in baby's X-ray, court hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |access-date=25 August 2023 |work=BBC News |date=21 October 2022 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824061847/https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |url-status=live }}</ref> The mother had noted Letby "hovering around" the family hours before the baby collapsed.<ref name="Time-s" />
On 2 July, a doctor raised his concerns over the sudden collapses and deaths.<ref name="Guardian timeline"/> No action was taken against Letby.<ref name="Guardian timeline"/> At about 9{{nbsp}}pm on 3 August, the mother of Child E, who had come to the neonatal unit to give him and twin Child F her expressed breast milk, rushed into the room of Child E, having been alarmed by a scream. She found the child having fresh blood around the mouth and being in extreme distress. Letby, standing near<ref name="near"/> to his incubator, was described by the mother as "not doing anything" in the face of the apparent emergency.{{R|Panorama|at=3:30}} The mother would recount seeing Letby then as someone who "wants to look busy but they're not actually doing anything".{{R|Panorama|at=3:30}} Letby said that the bleeding had merely been from a rubbing feeding tube and asked the mother to calm down.<ref name="near">{{cite web|url=https://www.theguardian.com/uk-news/2023/aug/18/lucy-letby-how-did-a-nurse-commit-such-unthinkable-murders|title=Lucy Letby: how did a nurse commit such unthinkable murders?|first=Josh|last=Halliday|work=The Guardian|date=18 August 2023|access-date=13 October 2023}}</ref> The boy died in the early hours of 4 August after having lost about a quarter of his blood, a "striking" amount according to a blood specialist testifying at court, who agreed with defence that her observations did not help establish a cause of death; injection of air was another suspected reason for the death.<ref name="Guardian timeline"/><ref>{{cite news| title=Lucy Letby: Baby's catastrophic bleed not spontaneous, trial told|first=Daniel|last=O'Donoghue|work=BBC News| date=29 November 2022| url=https://www.bbc.co.uk/news/uk-england-merseyside-63798909| access-date=30 August 2023| archive-date=24 January 2023| archive-url=https://web.archive.org/web/20230124133256/https://www.bbc.co.uk/news/uk-england-merseyside-63798909| url-status=live}}</ref> Flecks of blood were found in his vomit.<ref>{{cite news |title=Lucy Letby: Baby developed strange purple patches, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-63666826 |access-date=25 August 2023 |work=BBC News |date=17 November 2022 |archive-date=3 December 2022 |archive-url=https://web.archive.org/web/20221203023500/https://www.bbc.co.uk/news/uk-england-merseyside-63666826 |url-status=live }}</ref> No post-mortem was carried out.<ref name="bbc_20221116">{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-63651095|title=Lucy Letby trial: Consultant tells of baby post-mortem decision regret|first=Tom|last=Mullen|work=BBC News|date=16 November 2022|access-date=15 October 2023}}</ref> The next evening, Child E's twin brother Child F was being cared for in nursery 2, the same room in which Letby was looking after another infant.<ref name="Sky evidence" /><ref name="Guardian timeline"/> At 1:54 am Child F suffered an unexpected drop in his blood sugar and saw a surge in his heart rate.<ref name="Sky evidence" /> The child survived and a blood test later revealed that he had been given an "extremely high" amount of exogenous pharmaceutical insulin, which he had never needed.<ref name="Sky evidence" /><ref name="Guardian timeline"/> Later, at trial, Letby did not contest that the baby had been intentionally injected with insulin, suggesting someone else must have done it.<ref name="Time-s" /> Letby searched for the parents of Child E and F on social media in the following weeks and months, and for other parents who were not part of the case.<ref name="Christmas">{{cite news |title=Lucy Letby trial: Mum walked in on nurse killing baby, trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63214073 |access-date=25 August 2023 |work=BBC News |date=11 October 2022 |archive-date=7 June 2023 |archive-url=https://web.archive.org/web/20230607075344/https://www.bbc.co.uk/news/uk-england-merseyside-63214073 |url-status=live }}</ref><ref name="face">{{cite news |title=Lucy Letby trial: Mother found baby with blood on face, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63624914 |first=Daniel |last=O'Donoghue |access-date=25 August 2023 |work=BBC News |date=14 November 2022 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215106/https://www.bbc.co.uk/news/uk-england-merseyside-63624914 |url-status=live }}</ref>
On 7 September 2015, Child G, on her 100th day of being alive, collapsed for the first of three times in the following three weeks.<ref name="Guardian timeline"/> After the first collapse, the baby girl was taken to [[Arrowe Park Hospital]], but five days later she collapsed again, 15 minutes after Letby had been feeding her.<ref name="Guardian timeline"/> The child survived, but is now severely disabled as a result of what happened to her.<ref name="Guardian timeline"/> The baby was witnessed projectile vomiting so massively that it reached the chair next to the cot and canopy.<ref name="Vomit">{{cite news |title=Lucy Letby: No natural cause for baby's vomiting, doctor tells trial |url=https://www.bbc.co.uk/news/uk-england-merseyside-63947039 |access-date=25 August 2023 |work=BBC News |date=12 December 2022 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824061859/https://www.bbc.co.uk/news/uk-england-merseyside-63947039 |url-status=live }}</ref> Her heart rate and oxygen levels also dropped to unusually low levels.<ref name="Vomit" /> Later, at trial, an expert witness doctor concluded that the only viable explanation for the baby vomiting so extraordinarily was if she had received far more milk than that allocated down her feeding tube and that this could not happen accidentally.<ref name="Vomit" /> It was later discovered that Letby had deliberately altered the baby's temperature on her observation chart to make it seem like she was already unwell before she collapsed, and also falsified the time of the baby's collapse to make it seem like it coincided with when a colleague gave the baby a milk feed.<ref name="Time-s" /> A nurse noticed when she arrived after Letby's cry for help after one of the baby girl's collapses that the machine connected to the baby to measure its oxygen saturations and heart rate levels had been turned off.<ref name="Time-s" /> The nurse stated in court that two doctors had apologized to her for not having the machine switched back on after fitting a [[cannula]] to the baby girl. One of the doctors concerned told the court that he did not remember the apology but considered it possible that it had taken place. He agreed that leaving the monitor switched off was "not normal protocol" and possibly a result of his having to rush to another emergency.<ref>{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-63975758|title=Lucy Letby: Doctor cannot recall baby monitor error, trial told |first=Daniel |last=O'Donoghue |work=BBC News |date=14 December 2022 |access-date=7 October 2023}}</ref> A colleague had also noticed that Child G's initial collapse occurred on the day she was originally due to be born.<ref>{{cite news |title=Lucy Letby: Mum praised nurse on day of alleged murder attempt, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63962066 |first=Daniel |last=O'Donoghue |access-date=25 August 2023 |work=BBC News |date=13 December 2022 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215113/https://www.bbc.co.uk/news/uk-england-merseyside-63962066 |url-status=live }}</ref>
About six weeks after Child G's multiple collapses, on 23 October 2015, Child I died.<ref name="Guardian timeline"/> This was the fourth time the baby girl had collapsed.<ref name="Guardian timeline"/> On the fourth collapse, Letby was found next to her incubator by another nurse.<ref name="Light"/> Letby later sent a sympathy card to the baby girl's parents on the day of her funeral, a card which Letby kept photos of on her phone.<ref name="Guardian timeline"/><ref name="Sky evidence" /><ref name="Five key"/> Letby also wanted to go to the funeral.<ref>{{cite news |title=Lucy Letby trial: Accused nurse wanted to attend baby's funeral |url=https://www.bbc.co.uk/news/uk-england-merseyside-65390543 |access-date=25 August 2023 |work=BBC News |date=25 April 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215250/https://www.bbc.co.uk/news/uk-england-merseyside-65390543 |url-status=live }}</ref> Twice the baby was found to have excess air in her stomach which had affected her breathing.<ref name="Light"/> Before the second collapse, Letby had said to a colleague that Child I 'looked pale', even though it would have been hard to see from where they were standing in a doorway looking into the darkened nursery.<ref name="Time-s" /> Then, when the designated nurse for the child turned the light on, she saw the girl was not breathing.<ref name="Light">{{cite news |title=Lucy Letby trial: Nurse killed baby and sent parents card, trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63228147 |access-date=25 August 2023 |work=BBC News |date=12 October 2022 |archive-date=7 June 2023 |archive-url=https://web.archive.org/web/20230607075320/https://www.bbc.co.uk/news/uk-england-merseyside-63228147 |url-status=live |url-access=subscription}}</ref> The child's mother later said Letby 'smiled' as she bathed her dead daughter and offered to take photos of the dead child.<ref name="Time-s" /><ref name="Smiling">{{cite news |title=Lucy Letby: Nurse murdered baby on fourth attempt, court told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64402636 |first=Lauren |last=Hirst |access-date=25 August 2023 |work=BBC News |date=10 February 2023 |archive-date=26 August 2023 |archive-url=https://web.archive.org/web/20230826005845/https://www.bbc.co.uk/news/uk-england-merseyside-64402636 |url-status=live }}</ref> A doctor had seen unusual skin mottling on Child I's skin and X-rays showed the child had a massively enlarged stomach that was consistent with her having been deliberately injected with air.<ref>{{cite news |title=Lucy Letby: Baby had unusual skin mottling, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-64492832 |access-date=25 August 2023 |work=BBC News |date=1 February 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825052736/https://www.bbc.co.uk/news/uk-england-merseyside-64492832 |url-status=live }}</ref><ref>{{cite news |title=Lucy Letby trial: Expert believes baby was given lethal air injection |url=https://www.bbc.co.uk/news/uk-england-merseyside-64516659 |access-date=25 August 2023 |work=BBC News |date=3 February 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825052708/https://www.bbc.co.uk/news/uk-england-merseyside-64516659 |url-status=live }}</ref> Letby later searched for Child I's mother on Facebook.<ref name="Smiling"/>
Later on 23 October, the hospital management was alerted to the concerns of the doctors on the unit.<ref name="Guardian timeline"/> They were told to "not make a fuss".<ref name="Guardian timeline"/> Staff reviews were carried out which highlighted that Letby was always on duty for the suspicious incidents and in February 2016 a doctor requested an "urgent" meeting with executives, but no meeting occurred until May 2016.<ref name="Guardian timeline"/>
By April 2016, Letby had been moved to day shifts because of the concerns about her and the suspicious collapses began occurring in the daytime.<ref name="Time-s" /> On 9 April 2016, two twin brothers suffered sudden collapses within hours of each other.<ref name="Guardian timeline"/> Tests found that Child L had insulin levels in his blood "at the very top of the scale that the equipment was capable of measuring".<ref name="Guardian timeline"/> Hours later, twin brother Child M's heart rate and breathing suddenly dropped and he nearly died.<ref name="Guardian timeline"/> Experts said that Child M's heart problems were likely to have been caused by air being injected into his bloodstream.<ref name="Channel 4">{{cite AV media
| people = [[Channel 4 (UK)]]
| date = 19 August 2023
| title = Lucy Letby: the full story of the serial killer nurse
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| access-date = 25 August 2023
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}}</ref>{{R|Channel 4|at=3:00}} Although he lived, the child suffers from brain damage.<ref name="Guardian timeline"/> It was noted that the collapses of Child L and M occurred in almost identical circumstances to Child E and F.<ref name="Time-s" /> Both were twins where one was believed to have been injected with insulin and the other with air.<ref name="Time-s" /> Child F had survived his injection of insulin and it was noted that Child L had been injected with twice the dose of insulin, the suggestion being that Letby had done so to ensure death on this occasion.<ref name="Time-s" />
A meeting about the suspicious cases took place on 11 May 2016, but no action was taken.<ref name="Guardian timeline"/>
A month later, Child N nearly died after suffering trauma to the throat.<ref name="Guardian timeline"/> Doctors saw blood and "unusual" swelling at the back of his throat upon examination.<ref name="Child N">{{cite news |title=Doctors saw blood in baby's throat, nurse trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64863527 |access-date=25 August 2023 |work=BBC News |date=6 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214801/https://www.bbc.co.uk/news/uk-england-merseyside-64863527 |url-status=live }}</ref> The baby had been heard randomly "screaming", the jury was told.<ref>{{cite news |title=Lucy Letby: Baby was heard screaming before collapse, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64880004 |first=Daniel |last=O'Donoghue| access-date=25 August 2023 |work=BBC News |date=7 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215131/https://www.bbc.co.uk/news/uk-england-merseyside-64880004 |url-status=live }}</ref> Child N's father said he then saw blood spattered around his son's mouth.<ref>{{cite news |title=Lucy Letby: Dad found baby spattered in blood, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-64825649 |access-date=25 August 2023 |work=BBC News |date=2 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214801/https://www.bbc.co.uk/news/uk-england-merseyside-64825649 |url-status=live }}</ref>
The final two cases occurred within hours of each other on 23 and 24 June 2016.<ref name="Guardian timeline"/> The two children involved were triplets, siblings of each other, and the cases occurred on Letby's first shift back after a holiday in [[Ibiza]].<ref name="Time-s" /><ref name="Guardian timeline"/><ref>{{cite news |title=Lucy Letby: Babies died within 72 hours of nurse's text, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-65844522 |access-date=25 August 2023 |work=BBC News |date=8 June 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215200/https://www.bbc.co.uk/news/uk-england-merseyside-65844522 |url-status=live }}</ref> Child O, a "perfect" healthy baby, was due to be discharged home, but suddenly collapsed on 23 June.<ref name="Guardian timeline"/> When the child initially became unwell, another nurse suggested he be moved to nursery 1 where the sickest children were treated, but Letby disagreed and the baby subsequently collapsed less than two hours later.<ref name="Sky evidence" /> He recovered, but suffered two further collapses and died almost exactly three hours later.<ref name="Sky evidence" /> The lead consultant noted that the child "should have responded better" to resuscitation.<ref name="Sky evidence" /> X-rays on a post-mortem showed he had an abnormal amount of gas in his body and liver damage that an independent pathologist later ruled had resulted from an "impact injury" similar to what would be seen in a car crash.<ref name="Time-s" /><ref name="Guardian timeline"/> 13 minutes after Child O's death, Letby was feeding his triplet brother Child P, who also was expected to be able to soon go home, but he collapsed after his diaphragm was somehow shattered.<ref name="Guardian timeline"/>{{R|Channel 4|at=4:40}} Doctors believed he would make a full recovery. As they prepared him to go to another hospital, Letby said: "He's not leaving here alive, is he?".<ref name="Guardian timeline"/> The boy soon died.<ref name="Guardian timeline"/> X-rays likewise showed an inexplicable amount of gas inside the baby.<ref name="Hawk">{{cite news |title=Lucy Letby: Unusual amount of gas in baby, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-64984212 |access-date=25 August 2023 |work=BBC News |date=16 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214820/https://www.bbc.co.uk/news/uk-england-merseyside-64984212 |url-status=live }}</ref> These deaths have been described as "exceptional" and the "tipping point" when the consultants realised that "drastic" action needed to be taken.{{R|Channel 4|at=4:40}}{{R|Channel 4|at=12:35}} A consultant allowed the surviving triplet to be taken to a different hospital by medics who had turned up to take Child P.<ref name="Time-s" /> The consultant said she allowed this after her parents begged for it, as she now felt Letby was a "mortal danger" to the surviving triplet.<ref name="Time-s" /> Before the second triplet died, Letby had texted a doctor saying she would "be watching them both [Child P and the surviving triplet] like a hawk" and said "I'm OK. Just don't want to be here really. Hoping I may get the new admissions".<ref name="Hawk"/>
Towards the end of June 2016, Letby was removed from the neo-natal ward{{R|Panorama|at=29:00}} and instead moved to a clerical role within the hospital,<ref>{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-65040718|title=Lucy Letby: Doctors resisted nurse's frontline return, trial hears|first=Daniel|last=O'Donoghue|work=BBC News|date=22 March 2023|access-date=14 October 2023}}</ref> and the suspicious collapses stopped.{{R|Panorama|at=29:00}}
===Prosecutions, trials and convictions===
====Arrest and charges====
On 3 July 2018, Letby was arrested by police on suspicion of eight counts of murder and six counts of attempted murder, following a year-long investigation.<ref name="bbc">{{cite news |date=4 July 2018 |title=Nurse Lucy Letby arrested over Chester Hospital baby deaths |url=https://www.bbc.co.uk/news/uk-england-merseyside-44709766 |access-date=5 July 2018 |work=[[BBC News]] |archive-date=5 July 2018 |archive-url=https://web.archive.org/web/20180705051804/https://www.bbc.co.uk/news/uk-england-merseyside-44709766 |url-status=live}}</ref> Letby's home at Chester was searched by police following her arrest.<ref>{{Cite news |last=Powell |first=Tom |date=4 July 2018 |title=Nurse's home searched by police following baby murder arrests |url=https://www.standard.co.uk/news/crime/police-search-home-of-nurse-lucy-letby-after-healthcare-worker-arrested-on-suspicion-of-murdering-eight-babies-at-chester-hospital-a3878676.html |access-date=28 October 2022 |work=Evening Standard |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028125901/https://www.standard.co.uk/news/crime/police-search-home-of-nurse-lucy-letby-after-healthcare-worker-arrested-on-suspicion-of-murdering-eight-babies-at-chester-hospital-a3878676.html |url-status=live }}</ref> After Letby's arrest the investigation was widened to include Liverpool Women's Hospital, another location at which Letby had worked. Police have begun looking into Letby's entire career, including at Liverpool Women's Hospital, since her conviction.<ref name="parveen">{{cite news |last1=Parveen |first1=Nazia |last2=Halliday |first2=Josh |date=4 July 2018 |title=Cheshire baby deaths: police widen inquiry to second hospital |work=[[The Guardian]] |url=https://www.theguardian.com/uk-news/2018/jul/04/cheshire-baby-deaths-nurse-questioned-suspicion-murder-lucy-letby |access-date=5 July 2018 |archive-date=4 July 2018 |archive-url=https://web.archive.org/web/20180704163609/https://www.theguardian.com/uk-news/2018/jul/04/cheshire-baby-deaths-nurse-questioned-suspicion-murder-lucy-letby |url-status=live }}</ref><ref name="skynews_202308">{{Cite news |title=How the police caught Lucy Letby |url=https://news.sky.com/story/how-the-police-caught-lucy-letby-12933640 |first1=Megan|last1=Harwood-Baynes|first2=Tom|last2=Parmenter|access-date=18 August 2023 |work=Sky News |archive-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818203022/https://news.sky.com/story/how-the-police-caught-lucy-letby-12933640 |url-status=live }}</ref><ref>{{Cite news |last=Humphries |first=Jonathan |date=4 July 2018 |title=Lucy Letby's training hospital helping police with baby death probe |url=https://www.chesterchronicle.co.uk/news/chester-cheshire-news/nurse-lucy-letby-trained-liverpool-14866135 |access-date=30 October 2022 |work=CheshireLive |archive-date=11 September 2018 |archive-url=https://web.archive.org/web/20180911172511/https://www.chesterchronicle.co.uk/news/chester-cheshire-news/nurse-lucy-letby-trained-liverpool-14866135 |url-status=live }}</ref>
Letby was bailed on 6 July 2018 as the police continued their inquiries.<ref name="6julyupdate">{{cite web |date=6 July 2018 |title=Update on Countess of Chester Hospital neonatal unit investigation |url=https://www.cheshire.police.uk/news-and-appeals/news/update-on-countess-of-chester-hospital-neonatal-unit-investigation/ |url-status=dead |archive-url=https://web.archive.org/web/20190226112746/https://www.cheshire.police.uk/news-and-appeals/news/update-on-countess-of-chester-hospital-neonatal-unit-investigation/ |archive-date=26 February 2019 |access-date=13 July 2018 |website=cheshire.police.uk |publisher=[[Cheshire Constabulary]]}}</ref> She was rearrested on 10 June 2019 on suspicion of eight cases of murder and nine cases of attempted murder in relation to the cases described above, and released on bail on 13 June.<ref>{{cite web|url=https://www.theguardian.com/uk-news/2019/jun/13/nurse-lucy-letby-released-on-bail-in-chester-baby-deaths-inquiry|title=Nurse released on bail in Chester baby deaths inquiry|agency=[[PA Media|Press Association]]|work=The Guardian|date=13 June 2019|access-date=14 October 2023}}</ref> She was arrested again on 10 November 2020.<ref name="bbc2020">{{cite news |date=10 November 2020 |title=Chester hospital baby deaths probe: Nurse Lucy Letby rearrested |url=https://www.bbc.co.uk/news/uk-england-merseyside-54886213 |work=BBC News |access-date=25 October 2022 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027035241/https://www.bbc.co.uk/news/uk-england-merseyside-54886213 |url-status=live }}</ref><ref name="Guardian_11Nov2020">{{cite news |date=11 November 2020 |title=Nurse Lucy Letby charged with murder after Chester hospital baby deaths |work=The Guardian |agency=PA Media |url=https://www.theguardian.com/uk-news/2020/nov/11/nurse-lucy-letby-charged-with-murder-over-chester-hospital-baby-deaths |access-date=25 October 2022 |archive-date=15 October 2022 |archive-url=https://web.archive.org/web/20221015090403/https://www.theguardian.com/uk-news/2020/nov/11/nurse-lucy-letby-charged-with-murder-over-chester-hospital-baby-deaths |url-status=live }}</ref> There were thousands of exhibits in the investigation, 16,571 of which were not even used as evidence and some of the items were themselves thousands of pages long.<ref name="CC documentary">{{cite AV media
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}}</ref>{{R|CC documentary|at=37:30}} The 2019 arrest and bailing had been made as by this time three further cases of attempted murder had been identified which investigators needed to question Letby further on and as Letby had been found to have written extensively about the case on her 2018 arrest, detectives wished to see whether she had written anything further in the year while she was under investigation.{{R|CC documentary|at=21:30}}
On 13 March 2020, Letby was placed on an interim suspension by the [[Nursing and Midwifery Council]].<ref>[https://www.nmc.org.uk/globalassets/sitedocuments/ftpoutcomes/2023/march-2023/reasons-letby-icio-67757-20230313.pdf Nursing and Midwifery Council Investigating Committee] {{Webarchive|url=https://web.archive.org/web/20230818192036/https://www.nmc.org.uk/globalassets/sitedocuments/ftpoutcomes/2023/march-2023/reasons-letby-icio-67757-20230313.pdf |date=18 August 2023 }} nmc.org. Retrieved 21 August 2023.</ref>
On 11 November 2020, Letby was charged with eight counts of murder and 10 counts of attempted murder.<ref name="Guardian_11Nov2020" /> She was denied bail and remanded in police custody.<ref>{{cite news |last1=Goddard |first1=Ben |date=13 November 2020 |title=Hereford Nurse Lucy Letby Refused Bail |work=Hereford Times |url=https://www.herefordtimes.com/news/18871228.nurse-accused-murdering-eight-babies-appears-court/ |access-date=18 November 2022 |archive-date=18 November 2022 |archive-url=https://web.archive.org/web/20221118002328/https://www.herefordtimes.com/news/18871228.nurse-accused-murdering-eight-babies-appears-court/ |url-status=live }}</ref> The [[Crown Prosecution Service]] were convinced to approve all of the charges Cheshire Constabulary requested against Letby after it reviewed the evidence the force collected against her.{{R|CC documentary|at=30:30}} Letby denied all charges against her, and pointed to issues of hospital hygiene and staffing levels.<ref>{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-65960506|title=Lucy Letby: Jury retires in trial of nurse accused of baby murders|first=Daniel|last=O'Donoghue|work=[[BBC News]]|date=10 July 2023|access-date=27 February 2024}}</ref>
On 18 August 2023, [[Andrea Sutcliffe]], Chief Executive and Registrar of the Nursing and Midwifery Council, stated that Letby "remains suspended from our register, and we will now move forward with our regulatory action, seeking to strike her off the register".<ref>{{cite web|url=https://www.nmc.org.uk/news/news-and-updates/nmc-responds-to-verdict-in-lucy-letby-trial/|title=NMC responds to verdict in Lucy Letby trial - The Nursing and Midwifery Council|website=www.nmc.org.uk|accessdate=21 August 2023|archive-date=21 August 2023|archive-url=https://web.archive.org/web/20230821190623/https://www.nmc.org.uk/news/news-and-updates/nmc-responds-to-verdict-in-lucy-letby-trial/|url-status=live}}</ref>
====2023 trial====
Letby's trial began at [[Manchester Crown Court (Crown Square)|Manchester Crown Court]] on 10 October 2022 before [[James Goss (judge)|Mr Justice Goss]].<ref>{{Cite news |last=McIntyre |first=Alex |date=30 September 2022 |title=Lucy Letby trial to begin as nurse denies murdering babies at Chester Hospital |url=https://www.cheshire-live.co.uk/news/chester-cheshire-news/lucy-letby-trial-set-begin-25147312 |access-date=28 October 2022 |work=CheshireLive |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028155256/https://www.cheshire-live.co.uk/news/chester-cheshire-news/lucy-letby-trial-set-begin-25147312 |url-status=live }}</ref><ref>{{cite news |last1=Halliday |first1=Josh |date=12 October 2022 |title=Doctor interrupted nurse Lucy Letby's attempt to kill newborn baby, court told |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/12/lucy-letby-mother-bathed-baby-court |access-date=13 October 2022 |archive-date=12 October 2022 |archive-url=https://web.archive.org/web/20221012225319/https://www.theguardian.com/uk-news/2022/oct/12/lucy-letby-mother-bathed-baby-court |url-status=live }}</ref> She pleaded not guilty to seven counts of murder and 15 counts of attempted murder.<ref name="Halliday-2022-10-10">{{cite news |last1=Halliday |first1=Josh |date=10 October 2022 |title=Lucy Letby was 'constant malevolent' presence on neonatal ward, court hears |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/10/lucy-letby-constant-malevolent-presence-neonatal-ward-court-hears |access-date=13 October 2022 |archive-date=12 October 2022 |archive-url=https://web.archive.org/web/20221012185735/https://www.theguardian.com/uk-news/2022/oct/10/lucy-letby-constant-malevolent-presence-neonatal-ward-court-hears |url-status=live}}</ref> Letby's parents and the families of the victims attended the trial.<ref>{{Cite news |title=Lucy Letby's parents arrive at court |newspaper=Yahoo News |date=26 October 2022 |agency=ITN |url=https://uk.news.yahoo.com/lucy-letbys-parents-arrive-court-121820117.html |access-date=28 October 2022 |via=uk.news.yahoo.com |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145714/https://uk.news.yahoo.com/lucy-letbys-parents-arrive-court-121820117.html |url-status=live }}</ref><ref>{{Cite news|title=Latest updates: Hereford nurse Lucy Letby goes on trial accused of baby murders |url=https://www.herefordtimes.com/news/23017427.lucy-letby-hereford-nurse-goes-trial-accused-baby-murders/ |access-date=28 October 2022 |work=Hereford Times |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145714/https://www.herefordtimes.com/news/23017427.lucy-letby-hereford-nurse-goes-trial-accused-baby-murders/ |url-status=live }}</ref>
The child victims were referred to as Child A to Child Q.<ref>{{cite news |date=14 October 2022 |title=Who are the children alleged to have been murdered by Lucy Letby? |url=https://www.itv.com/news/granada/2022-10-14/who-are-the-children-alleged-to-have-been-murdered-by-lucy-letby |access-date=28 October 2022 |work=ITV News |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028125900/https://www.itv.com/news/granada/2022-10-14/who-are-the-children-alleged-to-have-been-murdered-by-lucy-letby |url-status=live}}</ref> The press secrecy around the identities of the 17 babies and nine colleagues who gave evidence was "rarely seen outside proceedings involving matters of national security."<ref name="Pidd 20230818">{{cite news |last1=Pidd |first1=Helen |title=Lucy Letby trial: why the babies remain anonymous |url=https://www.theguardian.com/uk-news/2023/aug/18/lucy-letby-trial-why-babies-remain-anonymous |access-date=18 August 2023 |work=The Guardian |date=18 August 2023 |archive-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818153702/https://www.theguardian.com/uk-news/2023/aug/18/lucy-letby-trial-why-babies-remain-anonymous |url-status=live }}</ref> Two years before the criminal trial, [[Karen Steyn|Mrs Justice Steyn]] banned the identification of the living victims until their 18th birthdays. Parents wanted their identifying information to be protected, though Steyn ruled that one parent's profession as a physician was relevant because of his medical expertise and that it would not make that parent identifiable to the public. Several witnesses requested anonymity, including a doctor with whom Letby was said to be infatuated. The judge approved these requests, ruling that getting testimony from the colleagues was more important than them being publicly identifiable.<ref name="Pidd 20230818" />
The prosecutor said that Letby was a "constant malevolent presence" in the hospital's neonatal unit.<ref name="Halliday-2022-10-10"/> There were witnesses that had apparently walked in during, or just after, Letby's attacks. A mother of one of the victims said she had walked in on Letby trying to kill her baby, with Letby saying "Trust me, I'm a nurse" when interrupted.<ref>{{Cite news |date=11 October 2022 |title=Mother walked in on nurse Lucy Letby trying to kill baby, court told |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/11/lucy-letby-mother-walked-in-nurse-trying-kill-baby-court-told |access-date=28 October 2022 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145704/https://www.theguardian.com/uk-news/2022/oct/11/lucy-letby-mother-walked-in-nurse-trying-kill-baby-court-told |url-status=live }}</ref> Another mother had walked in hearing her baby screaming, to find her child had blood around his mouth with Letby in the room.{{R|Panorama|at=3:30}} Letby told the mother to go back to the ward.{{R|Panorama|at=4:35}} The baby's condition soon worsened and it later died in its parents' arms.{{R|Panorama|at=5:15}} The senior medical consultant who had not recommended a post-mortem examination at the time said later in court that she regretted her decision, which she said she had taken with a view to avoiding any further distress to the parents, who had expressed they were "not keen" to have a post-mortem carried out.<ref name="bbc_20221116"/> Afterwards, Letby bathed the deceased baby in front of her parents.{{R|Panorama|at=6:50}} Another mother of a baby, who had died in October 2015, recounted an uncomfortable experience of Letby bathing her child, recounting: "Lucy Letby and another nurse asked me if I wanted to bathe my baby. While we were bathing her, Lucy came back in. She was smiling and kept going on about how she was present at the first bath and how our daughter had loved it. I wished that she would just stop talking".{{R|Panorama|at=13:30}} Letby's apparent obsession with this baby and her family later continued; she sent a sympathy card to the parents after the baby's death on the day of its funeral.{{R|Panorama|at=13:55}}{{R|ITV|at=16:25}} Upon Letby's arrest it was found on her phone that she had photographed the card before she sent it and had still kept pictures of it.<ref name="Sky evidence" /><ref name="Five key">{{cite news |last1=Patrick |first1=Holly |title=Lucy Letby: Five key pieces of evidence presented during trial of nurse accused of murdering babies on hospital ward |url=https://www.independent.co.uk/tv/news/lucy-letby-trial-murder-evidence-b2386911.html |access-date=25 August 2023 |work=The Independent |date=19 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824143658/https://www.independent.co.uk/tv/news/lucy-letby-trial-murder-evidence-b2386911.html |url-status=live }}</ref>
In a text message sent to a friend on 9 April 2016 two hours after the collapse of Child M, Letby wrote: "Work has been shit but... I have just won £135 on [[Grand National]]!! [horse emoji]." and, in a group chat after the winning bet: "Unpacking party sounds good to me with my flavoured vodka ha ha."<ref>{{cite web|url=https://www.theguardian.com/uk-news/2023/feb/15/lucy-letby-nurse-accused-of-killing-babies-entered-grand-national-on-day-of-attempted|title=Lucy Letby: nurse won Grand National bet on day of attempted baby murders, court told|first=Josh|last=Halliday|work=The Guardian|date=15 February 2023|access-date=29 September 2023}}</ref> On the afternoon of 22 June 2016, following a holiday in [[Ibiza]], she texted a friend: "Probably be back in with a bang lol". Child O died the next day.<ref>{{cite web|url=https://news.sky.com/story/lucy-letby-trial-nurse-completely-out-of-control-after-holiday-court-hears-12906393|title=Lucy Letby trial: Nurse 'completely out of control' after holiday, court hears|first=Samuel|last=Osborne|work=[[Sky News]]|date=20 June 2023|access-date=5 October 2023}}</ref><ref>{{cite web|url=https://www.theguardian.com/uk-news/2023/may/16/lucy-letby-tells-court-killing-babies-was-not-on-her-mind-before-holiday|title=Lucy Letby tells court 'killing babies' was not on her mind before holiday|first=Nadeem|last=Badshah|work=[[The Guardian]]|date=16 May 2023|access-date=5 October 2023}}</ref> The texts were seen as important by the Crown Prosecution Service as it saw them in some instances as appearing to be similar to a live blogging of events.<ref name="CPS">{{cite web |title=Lucy Letby found guilty of baby murders |url=https://www.cps.gov.uk/mersey-cheshire/news/lucy-letby-found-guilty-baby-murders |website=Crown Prosecution Service (CPS) |access-date=25 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825231327/https://www.cps.gov.uk/mersey-cheshire/news/lucy-letby-found-guilty-baby-murders |url-status=live }}</ref> Letby had also told a colleague that taking Child A to the mortuary was "the hardest thing she ever had to do".<ref>{{Cite news |date=27 October 2022 |title=Lucy Letby trial: nurse described newborns' deaths as 'sad and cruel' |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/27/lucy-letby-trial-nurse-described-newborns-deaths-as-sad-and-cruel |access-date=28 October 2022 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027232242/https://www.theguardian.com/uk-news/2022/oct/27/lucy-letby-trial-nurse-described-newborns-deaths-as-sad-and-cruel |url-status=live }}</ref><ref>{{Cite news |title=Accused nurse Lucy Letby told colleague that taking first alleged murder victim to mortuary was hardest thing she'd ever had to do, court hears |url=https://news.sky.com/story/accused-nurse-lucy-letby-told-colleague-that-taking-first-alleged-murder-victim-to-mortuary-was-hardest-thing-shed-ever-had-to-do-court-hears-12723849 |access-date=28 October 2022 |work=Sky News |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145703/https://news.sky.com/story/accused-nurse-lucy-letby-told-colleague-that-taking-first-alleged-murder-victim-to-mortuary-was-hardest-thing-shed-ever-had-to-do-court-hears-12723849 |url-status=live }}</ref> Letby had also searched for the parents of several infant victims on Facebook, in one case on the anniversary of a baby's death.{{R|Panorama|at=45:40}}<ref>{{Cite news |date=19 October 2022 |title=Lucy Letby: Nurse searched for parents on Facebook, jury told |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63315104 |access-date=28 October 2022 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145713/https://www.bbc.com/news/uk-england-merseyside-63315104 |url-status=live}}</ref> In total Letby had searched for 11 of the families affected.<ref name="Sky evidence" /> When police had asked her why she had searched up the parents of Child O on the anniversary of its death, she had responded that she "could not explain why she would be doing it".<ref>{{cite news |title=Lucy Letby: Baby triplet died after trauma to liver, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64965091 |access-date=25 August 2023 |work=BBC News |date=15 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214801/https://www.bbc.co.uk/news/uk-england-merseyside-64965091 |url-status=live }}</ref> The prosecutor asserted Letby had injected air into the bloodstream of two victims and had used insulin to murder others. It was also revealed during the trial that Letby had to be told more than once not to enter a room where the parents of one of the victims were grieving.<ref>{{Cite news |date=31 October 2022 |title=Lucy Letby asked to leave baby's grieving family, trial hears |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63433599 |access-date=31 October 2022 |archive-date=31 October 2022 |archive-url=https://web.archive.org/web/20221031170925/https://www.bbc.com/news/uk-england-merseyside-63433599 |url-status=live }}</ref> Letby said, "It's always me when it happens."{{R|Panorama|at=15:35}}
Letby's defence lawyer said that Letby was "a dedicated nurse in a system which has failed," that the prosecution's case was "driven by the assumption that someone was doing deliberate harm combined with the coincidence on certain occasions of Miss Letby's presence," and that there had been a "massive failure of care in a busy hospital neonatal unit – far too great to blame on one person."<ref>{{Cite news|last=Lennox |first=Aaran |date=13 October 2022 |title=Lucy Letby a 'dedicated' nurse in 'system which has failed', court hears |url=https://www.dailypost.co.uk/news/north-wales-news/lucy-letby-dedicated-nurse-system-25257464 |access-date=27 October 2022 |work=North Wales Live |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027201018/https://www.dailypost.co.uk/news/north-wales-news/lucy-letby-dedicated-nurse-system-25257464 |url-status=live }}</ref> The defence argued that "extraordinary bleeding" in a baby boy murdered by Letby could have been caused by a rigid wire or tube.<ref>{{Cite news |title=Lucy Letby trial: Rigid wire or tube could have caused baby's 'extraordinary bleeding', court told |url=https://news.sky.com/story/lucy-letby-trial-rigid-wire-or-tube-could-have-caused-babys-extraordinary-bleeding-court-told-12750428 |access-date=19 November 2022 |work=Sky News |archive-date=19 November 2022 |archive-url=https://web.archive.org/web/20221119021335/https://news.sky.com/story/lucy-letby-trial-rigid-wire-or-tube-could-have-caused-babys-extraordinary-bleeding-court-told-12750428 |url-status=live }}</ref><ref>{{Cite news |date=24 November 2022 |title=Lucy Letby: 'Extremely high' dose of insulin found in baby allegedly poisoned |url=https://www.itv.com/news/granada/2022-11-24/lucy-letby-extremely-high-dose-of-insulin-found-in-baby-allegedly-poisoned |access-date=24 November 2022 |work=ITV News |archive-date=24 November 2022 |archive-url=https://web.archive.org/web/20221124161223/https://www.itv.com/news/granada/2022-11-24/lucy-letby-extremely-high-dose-of-insulin-found-in-baby-allegedly-poisoned |url-status=live }}</ref> The therapeutic use of insulin was denied by Letby's colleagues.<ref>{{Cite news |date=23 November 2022 |title=Lucy Letby colleagues tell murder trial they did not give baby insulin |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63735668 |access-date=24 November 2022 |archive-date=23 November 2022 |archive-url=https://web.archive.org/web/20221123223930/https://www.bbc.com/news/uk-england-merseyside-63735668 |url-status=live }}</ref>
A key piece of evidence was also given by a consultant who recounted that in February 2016 he had walked in and seen Letby standing over a baby and watching when they seemed to have stopped breathing.{{R|Panorama|at=22:45}} Letby was not doing anything despite the baby desaturating.{{R|Panorama|at=22:55}} When he asked her what was going on, she responded that he had only then just started declining.{{R|Panorama|at=23:05}} This baby went on to survive their collapse.{{R|Panorama|at=23:20}} By this stage all seven of the paediatrician consultants who worked on the neonatal ward agreed something was seriously wrong in the department.{{R|Panorama|at=23:25}} The deaths and near-deaths that were happening on the unit could not be medically explained.{{R|Panorama|at=24:30}} All the babies involved had been expected to live and so their deaths came out of the blue.{{R|ITV|at=11:17}} Previously, in the majority of times the premature babies had collapsed it had already been expected and in the very rare cases it was not already expected it could still be medically explained, unlike in all of these cases.{{R|ITV|at=11:30}} A paediatrician testified that he and other clinicians had previously raised concerns about Letby, but were told by hospital administration that they "should not really be saying such things" and "not to make a fuss." Another doctor testified that Letby commented an hour before one victim died, "He's not leaving here alive, is he?"<ref>{{Cite news |date=24 October 2022 |title=Lucy Letby trial: Nurse thought 'not again' over baby collapse |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63378514 |access-date=28 October 2022 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027163619/https://www.bbc.com/news/uk-england-merseyside-63378514 |url-status=live}}</ref><ref>{{Cite news |title=Lucy Letby trial hears how doctor raised concerns but was told 'not to make a fuss' |url=https://news.sky.com/story/lucy-letby-trial-hears-how-doctor-raised-concerns-but-was-told-not-to-make-a-fuss-12729381 |access-date=28 October 2022 |work=Sky News |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145706/https://news.sky.com/story/lucy-letby-trial-hears-how-doctor-raised-concerns-but-was-told-not-to-make-a-fuss-12729381 |url-status=live }}</ref><ref>{{Cite news |last1=Ball |first1=Tom |last2=Bunyan |first2=Bunyan |title=Lucy Letby trial: Doctor told 'not to make a fuss' over deaths of babies |work=[[The Times]] |url=https://www.thetimes.co.uk/article/lucy-letby-trial-doctor-told-not-to-make-a-fuss-over-deaths-of-babies-76x9t6wpr |access-date=28 October 2022 |issn=0140-0460 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028124625/https://www.thetimes.co.uk/article/lucy-letby-trial-doctor-told-not-to-make-a-fuss-over-deaths-of-babies-76x9t6wpr |url-status=live }}</ref>
Between March and June 2016 another three babies almost died while under Letby's care.{{R|Panorama|at=26:00}} Towards the end of June, she was helping to care for triplets.{{R|Panorama|at=26:05}} One died at 6 pm one evening and another of the triplets died less than 24 hours later, both under Letby's watch.{{R|Panorama|at=26:10}} Both of them had been in very good health and the deaths on consecutive days were causing staff considerable distress and shock, with the notable exception of Letby, who merely told one consultant that she would be back on shift the next day when she was asked if she was upset after the events of the two days.{{R|Panorama|at=26:25}} This was not the first time that twins/triplets had collapsed within 24 hours of each other while under Letby's care, as two twins had experienced collapses on consecutive days in August 2015.{{R|Panorama|at=37:00}} Only hours after one of the twins had died that month, the other became seriously unwell and it was only during the police investigation and after analysis of a blood sample that it was found that someone had intentionally poisoned the baby with insulin.{{R|Panorama|at=37:05}} This evidence had been missed for two years.{{R|Panorama|at=40:35}} The insulin, which had not been prescribed to the child, was identifiable as exogenous pharmaceutical insulin as C-peptide would be present in the specimen if the insulin had been produced by the baby.{{R|Panorama|at=39:45}}<ref name="Guardian timeline"/> Laboratory analysis also showed that Child L had been poisoned with insulin.<ref name="ITV">{{cite AV media
| people = [[ITV (TV Network)|ITV]]
| date = 19 August 2023
| title = Lucy Letby: The Nurse Who Killed
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| url = https://www.itv.com/watch/lucy-letby-the-nurse-who-killed/10a5003
| access-date = 23 August 2023
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}}</ref>{{R|ITV|at=9:40}}<ref name="List of all charges i">{{cite news |last1=Finnis |first1=Alex |title=Lucy Letby trial verdict explained: The full list of charges, and how many murders she's been found guilty of |url=https://inews.co.uk/news/lucy-letby-trial-verdict-explained-full-list-charges-murders-guilty-2556833 |access-date=23 August 2023 |work=i |date=18 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084037/https://inews.co.uk/news/lucy-letby-trial-verdict-explained-full-list-charges-murders-guilty-2556833 |url-status=live }}</ref> This was also significant as only hours later his twin brother, Child M, inexplicably collapsed while under Letby's care but managed to survive after thirty minutes of resuscitation.{{R|ITV|at=9:40}} It was believed that Letby had injected air into the latter's bloodstream.<ref name="List of all charges i" /> The prosecution also noted that, although by this point she was not supposed to work night shifts, Letby was caring for Child L as she specifically volunteered to do an extra shift to care for it, the prosecution arguing that she had seen an opportunity here to kill Child L where she had failed previously with Child F.<ref name="Light"/> Letby herself accepted at trial that the results showed that some victims had been deliberately injected with insulin and did not contest that someone must have administered it to them.<ref name="Contest">{{cite news |title=Lucy Letby appeal fund launched |url=https://www.telegraph.co.uk/news/2023/08/23/lucy-letby-campaigners-freedom-launch-fundraising-appeal/ |access-date=24 August 2023 |work=The Telegraph |date=23 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824022301/https://www.telegraph.co.uk/news/2023/08/23/lucy-letby-campaigners-freedom-launch-fundraising-appeal/ |url-status=live }}</ref> The night after Letby tried to murder Child F she went salsa dancing.<ref name="Salsa">{{cite news |title=Lucy Letby trial: Nurse went dancing after alleged murder bid, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63720819 |access-date=25 August 2023 |work=BBC News |date=22 November 2022 |archive-date=3 December 2022 |archive-url=https://web.archive.org/web/20221203023510/https://www.bbc.co.uk/news/uk-england-merseyside-63720819 |url-status=live }}</ref>
Although the consultants made their desire to have Letby removed from duties known to hospital staff after the triplet incident, this was refused and the next day another baby almost died under Letby's care.{{R|Panorama|at=26:20}} As well as in the two cases in which insulin poisoning had been proved, evidence provided by medical experts indicated that all the babies had been harmed intentionally.{{R|Panorama|at=42:05}} This evidence was given by experts specialising in areas of paediatric radiology, paediatric pathology, haematology, paediatric neurology and paediatric endocrinology, with two main medical experts who were consultant paediatricians.<ref name="CC">{{cite web |title=Nurse found guilty of the murder and attempted murder of premature babies |url=https://www.cheshire.police.uk/news/cheshire/news/articles/2023/8/nurse-found-guilty-of-the-murder-and-attempted-murder-of-premature-babies/ |website=Cheshire Constabulary |access-date=25 August 2023 |archive-date=23 August 2023 |archive-url=https://web.archive.org/web/20230823042648/https://www.cheshire.police.uk/news/cheshire/news/articles/2023/8/nurse-found-guilty-of-the-murder-and-attempted-murder-of-premature-babies/ |url-status=live }}</ref> Letby was the only staff member on duty for every one of the 25 suspicious incidents.{{R|Panorama|at=43:00}} After her removal from duty, and the downgrade of the unit,<ref name="Lintern" /><ref name="nursingtimes_20230818" /> to concentrate on lower risk babies, no further incidents were deemed suspicious.{{R|Panorama|at=29:15}}{{Better source needed|date=November 2023|reason=This source is based on, and includes interviews with those involved, and is contemporaneous with the event, so is [[WP:PRIMARY]] with a reporting slant. A suitable secondary source is required.}} Importantly, it was discovered that Letby had falsified patient records, covering her tracks by changing the times some babies collapsed to make sure she could not be placed at the scene.{{R|ITV|at=16:00}} [[Criminal psychologist]] Dr David Holmes states that the varied methods she used to attack her victims, such as insulin and air injections and overfeeding milk, would all have been specifically chosen as things that would dissipate and not be easily detected afterwards.{{R|Sky special|at=34:10}}
On the fourth day of trial, the prosecution presented a handwritten note from Letby which said "I am evil, I did this," and that she "killed them on purpose" because she "couldn't take care of them."<ref>{{Cite news |title=Lucy Letby trial – 'I am evil, I did this': Read the 'confession note' written by nurse accused of murdering seven babies |url=https://news.sky.com/story/lucy-letby-trial-i-am-evil-i-did-this-read-the-confession-note-written-by-nurse-accused-of-murdering-seven-babies-12718882 |access-date=27 October 2022 |work=Sky News |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027201008/https://news.sky.com/story/lucy-letby-trial-i-am-evil-i-did-this-read-the-confession-note-written-by-nurse-accused-of-murdering-seven-babies-12718882 |url-status=live }}</ref> It further stated "I killed them" and "I'll never marry or have children, I'll never know what it's like to have a family".{{R|Panorama|at=46:00}}<ref name="Never marry">{{cite news |title=Lucy Letby trial: Murder-accused nurse wrote 'I am evil', trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63238989 |access-date=25 August 2023 |work=BBC News |date=13 October 2022 |archive-date=23 August 2023 |archive-url=https://web.archive.org/web/20230823174311/https://www.bbc.co.uk/news/uk-england-merseyside-63238989 |url-status=live }}</ref><ref name="'Geek'" /> The defence argued that the note was "the anguished outpouring of a young woman in fear and despair when she realises the enormity of what's being said about her, in the moment to herself" and said that Letby had written it when she was dealing with employment issues, including a grievance procedure with the NHS Trust. Several other notes from Letby were shown in court, two of which said, "Why/how has this happened – what process has led to this current situation? What allegations have been made and by who? Do they have written evidence to support their comments?" And, "I haven't done anything wrong and they have no evidence so why have I had to hide away?". The prosecution said that Letby was expressing through the notes her frustration about not being allowed back to work in the neonatal unit.<ref>{{Cite news |title=Revealed: The 'I am evil' handwritten note by Lucy Letby found at her Chester home |url=https://www.leaderlive.co.uk/news/23046837.revealed-i-evil-handwritten-note-lucy-letby-found-chester-home/ |first=Mark|last=Dowling|access-date=28 October 2022 |work=The Leader |date=13 October 2022 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028195619/https://www.leaderlive.co.uk/news/23046837.revealed-i-evil-handwritten-note-lucy-letby-found-chester-home/ |url-status=live }}</ref> The police had also discovered that Letby had secretly kept medical documents at home relating to the care of the children.{{R|Panorama|at=44:00}} Jurors were told that 257 nursing handover sheets were found at addresses linked to Letby, of which 21 related to babies she had allegedly harmed.<ref>{{cite web|url=https://www.theguardian.com/uk-news/2023/apr/17/lucy-letby-initials-of-babies-on-dates-of-alleged-attacks-noted-in-diary-court-told|title=Lucy Letby: initials of babies noted in diary on dates of alleged attacks, court told|first=Josh|last=Halliday|work=The Guardian|date=17 April 2023|access-date=15 October 2023}}</ref> Her trial judge stated at sentencing that she had kept documents as "morbid records of the dreadful events surrounding the collapses of [her] victims and what [she] had done to them".<ref name="Sky evidence" /> The sensitive documents, which should never have left the hospital, contained the names of the babies and the documents had been stuffed and hidden away in shopping bags under her bed.<ref name="Sky evidence" />{{R|CC documentary|at=24:15}}{{R|Channel 4|at=7:00}} One note of medications given to a baby boy who had managed to survive after being on the brink of death, written on a paper towel, was found under Letby's bed.<ref name="Intensive2015" /> Letby claimed at trial that she had no means of destroying the confidential notes, yet the court heard a paper shredder which could have done so was found in her home.<ref name="Sky evidence" /> Her diary was also found to be marked with the initials of the babies she killed on the exact days they died.{{R|Channel 4|at=7:29}} It was within this diary that the note that stated "I am evil I did this" was tucked inside.{{R|Channel 4|at=7:36}} Furthermore, more notes were discovered that contained phrases such as "I'm sorry that you couldn't have a chance at life" , "I don't want to do this anymore", "how can life be this way?", "hate my life" and "help" in capital letters.<ref name="Sky evidence">{{cite news |last1=Williams |first1=Katie |title=The evidence seen during Lucy Letby's murder trial, from handwritten notes to cards for parents |url=https://news.sky.com/story/the-evidence-seen-during-lucy-letbys-murder-trial-from-handwritten-notes-to-cards-for-parents-12944606 |access-date=25 August 2023 |work=Sky News |date=22 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825093527/https://news.sky.com/story/the-evidence-seen-during-lucy-letbys-murder-trial-from-handwritten-notes-to-cards-for-parents-12944606 |url-status=live }}</ref><ref name="Love">{{cite news |title=Lucy Letby trial: Nurse's notes found in home search released |url=https://www.bbc.co.uk/news/uk-england-merseyside-65311400 |access-date=25 August 2023 |work=BBC News |date=18 April 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214758/https://www.bbc.co.uk/news/uk-england-merseyside-65311400 |url-status=live }}</ref> The prosecution said the notes were evidently confessions of guilt, rather than just the words of a woman in "distress".<ref name="Sky evidence" /> These notes and documents had been found in searches of Letby's home in Chester and of her parents' house in Hereford.<ref name="Sky evidence" />
Letby herself gave evidence to the court in May 2023, breaking down in tears and claiming she was made to feel as though she were incompetent but "meant no harm."<ref>{{Cite magazine |title=Nurse Lucy Letby Sobs on Witness Stand, Claims She Was 'Incompetent' But Meant No Harm |url=https://people.com/crime/lucy-letby-nurse-sobs-witness-stand-claims-incompetent-meant-no-harm/ |access-date=3 May 2023 |magazine=People Magazine |archive-date=3 May 2023 |archive-url=https://web.archive.org/web/20230503024119/https://people.com/crime/lucy-letby-nurse-sobs-witness-stand-claims-incompetent-meant-no-harm/ |url-status=live }}</ref> When asked why she wrote the "I am evil, I did this," Letby said, "I felt at the time that if I'd done something wrong I must be such an evil, awful person. I'd somehow been incompetent and had done something wrong which had affected those babies."<ref name="auto">{{Cite news |last=Jolly |first=Bradley |date=2 May 2023 |title=Nurse Lucy Letby explains 'I am evil' note found after she 'murdered 7 babies' |url=https://www.mirror.co.uk/news/uk-news/nurse-lucy-letby-explains-i-29867123 |access-date=3 May 2023 |work=Mirror |archive-date=3 May 2023 |archive-url=https://web.archive.org/web/20230503024109/https://www.mirror.co.uk/news/uk-news/nurse-lucy-letby-explains-i-29867123 |url-status=live }}</ref> Letby said that the allegations had negatively impacted her mental health, saying, "I don't think you can be accused of anything worse than that. I just changed as a person, my mental health deteriorated, I felt isolated from my friends on the unit. From a self-confidence point of view, it made me question everything about myself." It was observed that Letby eventually began to lose her composure in the witness box, asking for a number of unplanned breaks.{{R|Panorama|at=51:00}} It was also observed that she only broke down when talking about herself and the impact it had on her, which the prosecution said was "telling".{{R|ITV|at=15:00}} She had not shown any emotion in relation to the fate of the babies.{{R|ITV|at=15:05}} It was also noted that she repeatedly contradicted herself, muddled up her story and became more and more frustrated with the prosecution's questions, which was unlike her usual calm demeanour.<ref>{{cite news |title=Who is Lucy Letby? The 'average' nurse who became one of Britain's most notorious child killers |url=https://news.sky.com/story/who-is-lucy-letby-the-average-nurse-who-became-britains-most-prolific-child-killer-12943602 |access-date=26 August 2023 |work=Sky News |date=21 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825092123/https://news.sky.com/story/who-is-lucy-letby-the-average-nurse-who-became-britains-most-prolific-child-killer-12943602 |url-status=live }}</ref>
====Verdicts and sentencing====
Final verdicts were returned by the jury on 18 August 2023.<ref>{{cite news |last=Halliday |first=Josh |date=18 August 2023 |title=Calls to force court appearances as Lucy Letby refuses to attend sentencing |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/18/calls-to-force-court-appearances-as-lucy-letby-refuses-to-attend-sentencing |access-date=18 August 2023 |archive-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818153637/https://www.theguardian.com/uk-news/2023/aug/18/calls-to-force-court-appearances-as-lucy-letby-refuses-to-attend-sentencing |url-status=live }}</ref> Letby was found guilty of seven counts of murder of seven babies. She killed them by injecting them with air, overfeeding them, poisoning them with [[insulin]] and assaulting them with medical tools. She is the most prolific serial killer of children in modern British history.<ref name=BBCverdict>{{cite news|last1=O'Donoghue|last2=Moritz|last3=Hirst|last4= Lazaro|first1= Dan|first2= Judith|first3=Lauren|first4=Rachael|title= Nurse Lucy Letby guilty of murdering seven babies on neonatal unit|date=18 August 2023|url=https://www.bbc.co.uk/news/uk-england-merseyside-65960514 |access-date=18 August 2023 |work=BBC News |url-status=live |archive-url=https://web.archive.org/web/20230818190742/https://www.bbc.co.uk/news/uk-england-merseyside-65960514 |archive-date=18 August 2023}}</ref><ref>{{cite news |last=Sawyer|first=Patrick|title= Lucy Letby joins Myra Hindley on list of UK's worst child serial killers|url= https://www.telegraph.co.uk/news/2023/08/18/lucy-letby-ian-brady-uk-worst-serial-child-killers/|work= The Telegraph|date= 18 August 2023|access-date=19 August 2023 |url-status=live |archive-url=https://web.archive.org/web/20230819124715/https://www.telegraph.co.uk/news/2023/08/18/lucy-letby-ian-brady-uk-worst-serial-child-killers/ |archive-date=19 August 2023}}</ref>
Letby was also found guilty of seven counts of attempted murder of six infants. Letby was found not guilty on two counts of attempted murder.<ref name=BBCverdict/> The jury was unable to reach verdicts on six further attempted murder charges.<ref name=BBCverdict/> Nicholas Johnson <small>[[King's Counsel|KC]]</small> asked the court for 28 days to consider whether a retrial would be sought for these six counts.<ref>{{Cite news|url=https://www.bbc.com/news/uk-england-merseyside-65960514|title=Nurse Lucy Letby guilty of murdering seven babies on neonatal unit|work=BBC News|date=18 August 2023|accessdate=21 August 2023|archive-date=24 August 2023|archive-url=https://web.archive.org/web/20230824084038/https://www.bbc.com/news/uk-england-merseyside-65960514|url-status=live}}</ref>
On 21 August 2023, Letby was sentenced to [[life imprisonment in England and Wales|life imprisonment]] with a [[whole life order]], the most severe sentence possible under English law; she is the fourth woman in UK legal history to receive such a sentence.<ref>{{cite web|url=https://www.nationalworld.com/news/crime/whole-life-order-killers-female-uk-criminal-parole-lucy-letby-awaits-sentence-4261606 |title=Every female British murderer given a whole life order |work=National World |date=21 August 2023 |accessdate=21 August 2023}}</ref> Goss said that Letby committed "a cruel, calculated and cynical campaign of child murder involving the smallest and most vulnerable of children." In closing, he stated, "there was a deep malevolence bordering on sadism [...] you [Letby] have no remorse [...] there are no mitigating factors [...] the offences are of sufficient severity to require a whole life order."<ref name="BBC 66551231">{{cite news |title=Lucy Letby sentencing live: Nurse to spend rest of life in prison |url=https://www.bbc.co.uk/news/live/uk-66551231 |access-date=21 August 2023 |work=BBC News |date=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821120846/https://www.bbc.co.uk/news/live/uk-66551231 |url-status=live }}</ref><ref>{{cite web |title=Letby Sentencing Remarks |url=https://www.judiciary.uk/wp-content/uploads/2023/08/LETBY-Sentencing-Remarks.pdf |website=judiciary.gov.uk |publisher=Manchester Crown Court |access-date=23 August 2023 |date=21 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084037/https://www.judiciary.uk/wp-content/uploads/2023/08/LETBY-Sentencing-Remarks.pdf |url-status=live }}</ref>
Letby opted{{R|ITV|at=18:50}} not to attend the [[sentencing]] hearing and as such heard neither the various [[victim impact statement]]s which were read out, nor her sentence being passed.<ref name="BBC 66569311">{{cite news |date=21 August 2023 |title=Serial killer nurse Lucy Letby given whole-life sentence |work=BBC News |url=https://www.bbc.co.uk/news/uk-england-merseyside-66569311 |access-date=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821154940/https://www.bbc.co.uk/news/uk-england-merseyside-66569311 |url-status=live }}</ref><ref>{{cite news |last=Halliday |first=Josh |date=21 August 2023 |title=Lucy Letby sentenced to whole-life jail term for murdering seven babies |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-sentence-whole-life-jail-term-for-murdering-seven-babies |access-date=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821144644/https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-sentence-whole-life-jail-term-for-murdering-seven-babies |url-status=live }}</ref> In response, [[Alex Chalk]], [[Secretary of State for Justice (UK)|Secretary of State for Justice]], wrote that the government will "look at options to change the law at the earliest opportunity" to compel defendants to attend their sentencing.<ref>{{Cite news |last=Siddique |first=Haroon |last2= |first2= |last3= |first3= |date=21 August 2023 |title=Lucy Letby becomes fourth woman in UK to receive whole-life jail term after murdering seven babies – latest updates |work=The Guardian |url=https://www.theguardian.com/uk-news/live/2023/aug/21/lucy-letby-sentencing-hearing-life-sentence-updates |access-date=21 August 2023 |issn=0261-3077 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821190553/https://www.theguardian.com/uk-news/live/2023/aug/21/lucy-letby-sentencing-hearing-life-sentence-updates |url-status=live }}</ref> On 30 August 2023, Prime Minister [[Rishi Sunak]] announced that the [[Government of the United Kingdom|UK government]] would introduce legislation to Parliament that would compel convicted criminals to attend their sentencing hearings, by force if necessary, or face the prospect of more time in prison.<ref>{{cite web |first1=Tom |last1=Symonds |first2=Aoife |last2=Walsh |url=https://www.bbc.com/news/uk-66660136 |title=Criminals to be forced to attend sentencing hearings |work=BBC News |date=31 August 2023 |access-date=11 March 2024 |archive-url=https://web.archive.org/web/20230904190234/https://www.bbc.com/news/uk-66660136 |archive-date=4 September 2023 |url-status=live }}</ref>
After the trial, Lucy Letby was transferred to [[HMP Low Newton]], a [[Prison security categories in the United Kingdom|closed]] prison for women in [[County Durham]].<ref name="theguardian1">{{cite news |title=Inside Low Newton: the high security prison that will house Lucy Letby' |url=https://www.theguardian.com/uk-news/2023/aug/21/inside-low-newton-the-high-security-prison-that-is-housing-lucy-letby |access-date=21 August 2023 |newspaper=Guardian |date=21 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824083539/https://www.theguardian.com/uk-news/2023/aug/21/inside-low-newton-the-high-security-prison-that-is-housing-lucy-letby |url-status=live }}</ref> {{asof|January 2024}}, Letby is being held in [[HM Prison Bronzefield]].<ref>{{Cite web |date=2024-01-29 |title=Serial killer nurse Lucy Letby has 'keys to her own cell' and leads cushy life |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-serial-killer-nurse-prison-b2486468.html |access-date=2024-02-11 |website=The Independent |language=en}}</ref>
====Appeal====
In January 2024, Letby applied to the [[Court of Appeal (England and Wales)|Court of Appeal]] for permission to appeal her convictions which a judge refused. Letby renewed her application in February 2024. Following a three-day hearing in April 2024, three judges of the Court of Appeal reserved judgement, their written decision whether to grant permission to be issued at some later date.<ref name="Pidd 2024">{{cite news |first1=Helen |last1=Pidd |title=Child serial killer Lucy Letby loses initial attempt to challenge convictions |url=https://www.theguardian.com/uk-news/2024/jan/30/child-serial-killer-lucy-letby-loses-initial-attempt-challenge-convictions |website=The Guardian |date=30 January 2024 |access-date=30 January 2024 }}</ref><ref>{{Cite news |date=2024-02-07 |title=Lucy Letby renews bid to appeal her convictions |url=https://www.bbc.com/news/uk-england-manchester-68233226 |access-date=2024-02-18 |work=BBC News |language=en-GB}}</ref><ref name=":5">{{Cite web |title=Court of Appeal cases fixed for hearing (Criminal Division) |url=https://www.gov.uk/government/publications/court-of-appeal-cases-fixed-for-hearing-criminal-division/court-of-appeal-cases-fixed-for-hearing-criminal-division |access-date=2024-04-11 |website=GOV.UK |language=en}}</ref><ref>{{Cite web |date=2024-04-25 |title=Lucy Letby: Judges reserve judgement on appeal bid |url=https://www.bbc.com/news/articles/ce965klgv01o |access-date=2024-04-26 |website=BBC News |language=en-GB}}</ref>
====Scheduled retrial====
At a hearing on 25 September 2023, the CPS confirmed that there would be a retrial on one of the six counts of attempted murder against Letby on which the jury at the original trial could not reach a verdict. A date of 10 June 2024 has been set but the trial will not be conducted until after judges had decided whether or not to grant Letby permission to appeal against her existing convictions.<ref>{{cite news |last1=Halliday |first1=Josh |title=Lucy Letby to face retrial on charge of trying to murder baby girl, court told |url=https://www.theguardian.com/uk-news/2023/sep/25/lucy-letby-retrial |access-date=25 September 2023 |work=The Guardian |date=25 September 2023}}</ref>
===Disciplinary action===
Letby was removed from the nursing register on 12 December 2023, having informed the Nursing and Midwifery Council that she did not accept guilt but did not contest the removal.<ref>{{cite news |title=Convicted child serial killer Lucy Letby struck off nursing register |url=https://www.theguardian.com/uk-news/2023/dec/12/convicted-child-serial-killer-lucy-letby-struck-off-nursing-register |website=Guardian |date=12 December 2023 |access-date=12 December 2023 |last1=Media |first1=P. A. }}</ref>
===Motives===
During Letby's trial, the prosecution suggested several possible motives for the killings including boredom, that she "got a thrill" from the events surrounding the deaths and that she enjoyed "[[Playing God (ethics)|playing God]]". The prosecution told the jury that "[s]he was controlling things. She was enjoying what was going on. She was predicting things that she knew was going to happen." Another possible motivation suggested by the prosecution was that the killings were to gain the attention of a married doctor with whom Letby allegedly had a secret relationship. She had texted this doctor 'non-stop' during some night shifts, minutes before attacking babies.{{R|Panorama|at=14:30}} One sheet of paper found in Letby's office and shown to the court was an annual leave form, on which Letby had written phrases including, "I trusted you with everything and loved you", "you were my best friend" and "please help me".<ref name="Lovedyou">{{cite news |title=Lucy Letby trial: Nurse's notes read 'I killed them', jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-65299827 |access-date=25 August 2023 |work=BBC News |date=17 April 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215119/https://www.bbc.co.uk/news/uk-england-merseyside-65299827 |url-status=live }}</ref> The doctor was one of those called when a baby rapidly deteriorated. Letby denied all these suggestions, including the allegation that she had a relationship with the married doctor<ref name=Guardianmotives>{{cite news |last1=Halliday |first1=Josh |title=What were Lucy Letby's possible motives for murdering babies? |url=https://www.theguardian.com/uk-news/2023/aug/18/what-were-lucy-letbys-possible-motives-for-murdering-babies |work=The Guardian |date=18 August 2023 |access-date=19 August 2023|url-status=live |archive-url=https://web.archive.org/web/20230818234607/https://www.theguardian.com/uk-news/2023/aug/18/what-were-lucy-letbys-possible-motives-for-murdering-babies |archive-date=18 August 2023}}</ref> She denied that she had a crush on him and when asked why she tried to leave the dock without permission when he was giving evidence, Letby said she had "felt unwell".{{R|ITV|at=14:30}}<ref>{{cite news |title=Lucy Letby denies rooting in bin after baby resuscitation |url=https://www.bbc.co.uk/news/uk-england-merseyside-65834779 |access-date=25 August 2023 |work=BBC News |date=7 June 2023 |archive-date=26 August 2023 |archive-url=https://web.archive.org/web/20230826005841/https://www.bbc.co.uk/news/uk-england-merseyside-65834779 |url-status=live }}</ref>
''[[The Guardian]]'', in its reporting after the verdict, said that "[t]he closest the prosecution had to a confession" were [[Post-it Note|post-it notes]] found in Letby's handbag after her arrest. The notes bore hand-written jottings, one of which read, "I killed them on purpose because I'm not good enough to care for them." During the trial Letby denied this was a confession and that it was merely a reflection of her mental turmoil written while she was being investigated.<ref name=Guardianmotives/>'' [[The Telegraph (UK)|The Telegraph]]'' also noted though that she had also suggested another motivation was her fear of never finding love or having children of her own, writing on the note: "I'll never marry or have children, I'll never know what it's like to have a family."<ref name="'Geek'">{{cite news |title=Lucy Letby: Quiet 'geek' who became a killer feared she would never have children of her own |url=https://www.telegraph.co.uk/news/2023/08/18/how-lucy-letby-became-britains-most-prolific-baby-killer/ |access-date=26 August 2023 |work=The Telegraph |date=18 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825203936/https://www.telegraph.co.uk/news/2023/08/18/how-lucy-letby-became-britains-most-prolific-baby-killer/ |url-status=live }}</ref><ref name="Never marry" />
A former detective superintendent, the lead detective on the [[Beverley Allitt]] case of the 1990s, said that the amount of parallels between the cases made him think that "it's almost as if somebody's read the Allitt book" and that Letby's crimes may have been copycats.{{R|ITV|at=17:30}} Allitt had attacked over a dozen infants in her care while working as a nurse in [[Grantham]], England, and the methods used in the cases were apparently identical, with Allitt having also injected some victims with air and insulin and physically assaulting them.{{R|ITV|at=17:30}} It was believed that Allitt may have been motivated by what was then called [[Münchausen syndrome by proxy]], now known as factitious disorder imposed on another (FDIA), in which she harmed others to gain attention for herself. The theory that this could explain Letby's attacks was supported by [[criminal psychologist]] Dominic Wilmott.{{R|ITV|at=18:00}} Fellow criminal psychologist Dr David Holmes agreed that Letby was motivated by FDIA.<ref name="Sky special">{{cite AV media
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}}</ref><sup><!--|at=-->31:15</sup> Just like in Letby's case, the hospital in Allitt's case was criticised for its slow speed of response.<ref name="Newsnight">{{cite web |title=Lucy Letby: A timeline of the most prolific child killer in modern Britain - BBC Newsnight |url=https://www.youtube.com/watch?v=oVLx9U6MFXU |publisher=BBC News |access-date=25 August 2023 |date=22 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825161610/https://www.youtube.com/watch?v=oVLx9U6MFXU |url-status=live }}</ref>
In an opinion piece published in the [[The Guardian|Guardian]] in August 2023, [[David Wilson (criminologist)|David Wilson]], an emeritus professor of [[criminology]], considered it possible that Letby was driven by a "[[hero complex]]".<ref>{{cite web|url=https://www.theguardian.com/uk-news/commentisfree/2023/aug/20/lucy-letby-confirms-yet-confounds-our-ideas-of-a-serial-killer|title=Lucy Letby confirms yet confounds our ideas of a serial killer|first=David|last=Wilson|work=[[The Guardian]]|date=20 August 2023|access-date=15 March 2024}}</ref> A senior nurse testified on 21 March 2023 that Letby had told her before June 2016 that she, Letby, found non-intensive care of babies "boring" and had always wanted to be allocated to the intensive care unit, notwithstanding concerns among nursing staff that working long periods in intensive care would place a high burden on the mental health of nurses.<ref name="boring">{{cite news |title=Lucy Letby found caring for less sick babies 'boring', trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-65029970 |access-date=25 August 2023 |work=BBC News |date=21 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215129/https://www.bbc.co.uk/news/uk-england-merseyside-65029970 |url-status=live }}</ref> According to Wilson, healthcare killers like Letby "[have] already developed the desire to kill before they join the healthcare setting".<ref name="Newsnight" /> Speaking on ''[[Newsnight]]'', he said: "If you want to kill, of course you are going to identify people who are vulnerable. People whose deaths won't be noticed. And so guess what? The people that serial killers target, by and large, are older people, or they target very very young people, specifically in a neonatal unit in this case, where again small babies with chronic underlying healthcare where their deaths won't be commented upon or seen as being suspicious".<ref name="Newsnight" />
===Post-conviction===
====Further investigations====
Following the verdict, it was reported that police were investigating whether Letby harmed other babies. There was a continuing investigation of incidents which detectives had identified as "suspicious" at the Countess of Chester Hospital involving around 30 other infants. Neonatologists looked into about 4,000 admissions at the hospital and [[Liverpool Women's Hospital]], where Letby had worked from 2012 to 2015, and were to pass on any cases of "unexpected and unexplained" deteriorations to police. At least one family was told by police that the birth of their child at the latter hospital was part of the enquiry.<ref name="guardian_20230820">{{Cite news |last1=Halliday |first1=Josh |date=20 August 2023 |title=Lucy Letby may have harmed dozens more babies, police fear |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/20/lucy-letby-dozens-more-babies-police-believe-chester-liverpool |access-date=20 August 2023 |issn=0261-3077 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821021318/https://www.theguardian.com/uk-news/2023/aug/20/lucy-letby-dozens-more-babies-police-believe-chester-liverpool |url-status=live }}</ref><ref>{{cite news|last= Vaughan|first= Henry|url= https://news.sky.com/story/lucy-letby-more-families-told-their-children-may-be-victims-of-killer-nurse-12931797|title= Lucy Letby: More families told their children may be victims of killer nurse - as police review care of 4,000 babies|date= 18 August 2023|work= Sky News|accessdate= 20 August 2023|archive-date= 19 August 2023|archive-url= https://web.archive.org/web/20230819233901/https://news.sky.com/story/lucy-letby-more-families-told-their-children-may-be-victims-of-killer-nurse-12931797|url-status= live}}</ref> Cheshire Police have said that further charges could "possibly" be brought against Letby as a result of these further investigations.{{R|Panorama|at=55:20}}
On 4 October 2023, Cheshire Constabulary announced an investigation into [[Corporate manslaughter in English law|corporate manslaughter]] at the Countess of Chester Hospital.<ref>{{cite web |title=Cheshire Constabulary statement regarding Countess of Chester Hospital (4 October 2023) |url=https://www.cheshire.police.uk/news/cheshire/news/articles/2023/10/cheshire-constabulary-statement-regarding-countess-of-chester-hospital-4-october-2023/ |website=Cheshire Police |access-date=4 October 2023}}</ref>
====Thirlwall inquiry====
After Letby's conviction the UK government ordered an independent inquiry into the circumstances surrounding the murders.<ref>{{cite web|url=https://www.gov.uk/government/news/government-orders-independent-inquiry-following-lucy-letby-verdict|title=Government orders independent inquiry following Lucy Letby verdict|website=gov.uk|date=18 August 2023 |access-date=18 August 2023|archive-date=18 August 2023|archive-url=https://web.archive.org/web/20230818154140/https://www.gov.uk/government/news/government-orders-independent-inquiry-following-lucy-letby-verdict|url-status=live}}</ref> The [[Department of Health and Social Care]] said the inquiry would examine "the circumstances surrounding the deaths and incidents, including how concerns raised by clinicians were dealt with."<ref>{{cite news |url=https://www.itv.com/news/granada/2023-08-18/government-orders-independent-inquiry-into-nurse-who-murdered-babies-at-hospital |title=Lucy Letby: Government orders inquiry into nurse who murdered babies at hospital |work=ITV News |date=18 August 2023 |access-date=18 August 2023}}</ref> It was affirmed that the inquiry would be non-statutory, so witnesses could not be compelled to give evidence and inquests would still be necessary. The trust's medical director, chief executive and the nursing director at the time of the murders all commented they would fully cooperate with the inquiry.<ref>{{cite news|url=https://www.bbc.co.uk/news/uk-66547863|work=BBC News|title=Lucy Letby: Government orders independent inquiry|date=18 August 2023|access-date=19 August 2023|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820211315/https://www.bbc.co.uk/news/uk-66547863|url-status=live}}</ref><ref name=Lintern/> The medical director retired in August 2018 and the chief executive resigned in September 2018 after signing a non-disclosure agreement.<ref name=Lintern/>
[[Slater and Gordon]], a law firm representing two of the victims' families, issued a statement calling for the inquiry to have the power to compel witnesses to participate, since a non-statutory hearing "must rely on the goodwill of those involved to share their testimony."<ref name=BBC66553245/> The need for a statutory inquiry was a view echoed by, among others, [[Sir Robert Buckland]], former [[Secretary of State for Justice]],<ref>{{cite news |url=https://news.sky.com/story/lucy-letbys-refusal-to-appear-in-court-sparks-renewed-calls-for-change-to-law-12943015 |title=Lucy Letby's refusal to appear in court sparks renewed calls for change to law |work=Sky News |date=20 August 2023 |accessdate=20 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820142752/https://news.sky.com/story/lucy-letbys-refusal-to-appear-in-court-sparks-renewed-calls-for-change-to-law-12943015 |url-status=live }}</ref> [[Samantha Dixon]], MP for the [[City of Chester (UK Parliament constituency)|City of Chester]],<ref name=BBC66553245>{{cite news |url=https://www.bbc.co.uk/news/uk-66553245 |title=Lucy Letby: Families of victims call for greater powers in inquiry |work=BBC News |date=19 August 2023 |access-date=19 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820073714/https://www.bbc.co.uk/news/uk-66553245 |url-status=live }}</ref> [[Steve Brine]], chair of the [[Health and Social Care Select Committee|House of Commons Health and Social Care Select Committee]],<ref>{{cite news |first=James |last=Gregory |url=https://www.bbc.co.uk/news/uk-66562938 |title=Lucy Letby inquiry should be led by judge, committee chair says |work=BBC News |date=20 August 2023 |accessdate=20 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820175500/https://www.bbc.co.uk/news/uk-66562938 |url-status=live }}</ref> [[Sir Keir Starmer]], [[Leader of the Opposition (United Kingdom)|Leader of the Opposition]],<ref>{{cite news |url=https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-murders-victims-families-and-experts-call-for-statutory-inquiry |title=Lucy Letby inquiry could be upgraded to compel witnesses, No 10 indicates |work=[[The Guardian]] |date=21 August 2023 |first1=Pippa |last1=Crerar |author-link1=Pippa Crerar |first2=Josh |last2=Halliday |first3=Haroon |last3=Siddique |access-date=22 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821221641/https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-murders-victims-families-and-experts-call-for-statutory-inquiry |url-status=live }}</ref> and the Parliamentary and Health Service Ombudsman.<ref name="Ombudsman">{{cite web |title=Ombudsman writes to Health Secretary calling for statutory inquiry and action on patient safety in wake of Letby trial |url=https://www.ombudsman.org.uk/news-and-blog/news/ombudsman-writes-health-secretary-calling-statutory-inquiry-and-action-patient |website=Parliamentary and Health Service Ombudsman |access-date=29 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824155103/https://www.ombudsman.org.uk/news-and-blog/news/ombudsman-writes-health-secretary-calling-statutory-inquiry-and-action-patient |url-status=live }}</ref>
The education minister [[Gillian Keegan]] said that the type of inquiry would be reviewed after the chair was appointed.<ref>{{cite news |title=Lucy Letby: doctor who raised alarm calls for regulation of NHS executives |url=https://www.theguardian.com/society/2023/aug/22/lucy-letby-doctor-stephen-brearey-regulation-nhs-executives-call |first=Geneva|last=Abdul|work=The Guardian |access-date=22 August 2023 |archive-date=22 August 2023 |archive-url=https://web.archive.org/web/20230822093812/https://www.theguardian.com/society/2023/aug/22/lucy-letby-doctor-stephen-brearey-regulation-nhs-executives-call |url-status=live }}</ref><ref>{{cite news|url=https://www.theguardian.com/uk-news/2023/aug/25/ministers-indicate-support-for-statutory-inquiry-into-lucy-letby-killings|title=Ministers indicate support for statutory inquiry into Lucy Letby killing|work=The Guardian|date=25 August 2023 |access-date=26 August 2023|archive-date=26 August 2023|archive-url=https://web.archive.org/web/20230826050358/https://www.theguardian.com/uk-news/2023/aug/25/ministers-indicate-support-for-statutory-inquiry-into-lucy-letby-killings|url-status=live |last1=Rawlinson |first1=Kevin |last2=Mason |first2=Rowena }}</ref> On 30 August 2023, Health Secretary [[Steve Barclay]] announced that the inquiry had been upgraded to a [[statutory inquiry]], describing it as the best way forward and meaning that witnesses would be compelled to give evidence.<ref>{{cite web |url=https://www.bbc.co.uk/news/health-66597122 |title=Lucy Letby: Inquiry given powers to compel witnesses to give evidence |work=BBC News |date=30 August 2023 |access-date=30 August 2023 |archive-date=30 August 2023 |archive-url=https://web.archive.org/web/20230830175127/https://www.bbc.co.uk/news/health-66597122 |url-status=live }}</ref>
[[Kathryn Thirlwall|Lady Justice Thirlwall]] was appointed to chair the inquiry.<ref>{{cite news |title=Lady Justice Thirlwall appointed to lead public inquiry into Lucy Letby |url=https://www.theguardian.com/uk-news/2023/sep/04/lucy-letby-lady-justice-thirlwall-to-lead-public-inquiry |website=Guardian |date=4 September 2023 |access-date=4 September 2023 |last1=Siddique |first1=Haroon }}</ref> The terms of reference of the inquiry were published on 19 October 2023 and updated on 22 November 2023,<ref>{{cite web |title=Thirlwall Inquiry: terms of reference |url=https://www.gov.uk/government/publications/thirlwall-inquiry-terms-of-reference/thirlwall-inquiry-terms-of-reference |website=GOV.UK |access-date=22 November 2023}}</ref> when she formally opened the inquiry.<ref>{{Cite web |first1=Daniel |last1=O'Donoghue |first2=Judith |last2=Moritz |url=https://www.bbc.com/news/uk-england-merseyside-67488797 |title=Lucy Letby public inquiry formally opened by judge |date=22 November 2023 |accessdate=22 November 2023 |work=BBC News |publisher=BBC}}</ref>
====Calls for regulation and reform====
The [[British Medical Association]], which represents doctors, called for a process for NHS managers and healthcare administrators to be held accountable for mismanagement, in a similar way to how the [[General Medical Council]] may [[Struck off|strike off]] doctors who harm patients.<ref>{{cite news |last1=Malnick |first1=Edward |last2=Sawer |first2=Patrick |last3=Bird |first3=Steve |title=Doctors wage war on NHS managers after Letby murders |url=https://www.telegraph.co.uk/news/2023/08/19/doctors-wage-war-on-nhs-managers-after-lucy-letby-murders/ |access-date=20 August 2023 |work=[[The Daily Telegraph|The Telegraph]] |date=19 August 2023 |archive-url=https://archive.today/20230819205849/https://www.telegraph.co.uk/news/2023/08/19/doctors-wage-war-on-nhs-managers-after-lucy-letby-murders/ |archive-date=19 August 2023}}</ref> A neonatal consultant who alerted administrators about his suspicions about Letby also called for regulation of healthcare management.<ref>{{Cite news |date=22 August 2023 |title=Lucy Letby: NHS managers must be held to account, doctor says |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-66578698 |access-date=24 August 2023|archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824013557/https://www.bbc.com/news/uk-66578698 |url-status=live }}</ref>
The [[Parliamentary and Health Service Ombudsman]] Rob Behrens, called for radical change to NHS management in order to prevent future similar occurrences.<ref name="Ombudsman" /><ref>{{Cite news |last=Gregory |first=Andrew |last2= |first2= |date=2023-08-27 |title=Lucy Letby case: more babies face harm unless NHS ends 'defensive leadership' |language=en-GB |work=The Guardian |url=https://www.theguardian.com/society/2023/aug/27/lucy-letby-case-more-babies-face-harm-defensive-leadership-nhs-ombudsman |access-date=2023-08-29 |issn=0261-3077 |archive-date=27 August 2023 |archive-url=https://web.archive.org/web/20230827160605/https://www.theguardian.com/society/2023/aug/27/lucy-letby-case-more-babies-face-harm-defensive-leadership-nhs-ombudsman |url-status=live }}</ref>
====Doubts about conviction====
A small number of Letby's friends and former colleagues continued to believe in her innocence.<ref name="Evans 2023">{{Cite news |last=Evans |first=Holly |date=27 August 2023 |title=Friends and colleagues of murderer Lucy Letby insist baby killing nurse is innocent |work=Independent |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |access-date=28 August 2023 |archive-date=28 August 2023 |archive-url=https://web.archive.org/web/20230828215353/https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |url-status=live }}</ref> After the verdict, some analysts highlighted similarities between Letby's trial and the wrongful conviction of [[Lucia de Berk]].<ref name="Steafal 2023">{{cite news |title=How internet sleuths are already trying to prove Lucy Letby innocent |work=The Telegraph |url=https://www.telegraph.co.uk/news/2023/08/24/lucy-letby-appeal-internet-sleuths/ |url-status=live |date=24 August 2023|first1=Eleanor |last1=Steafel |access-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825025512/https://www.telegraph.co.uk/news/2023/08/24/lucy-letby-appeal-internet-sleuths/ |archive-date=25 August 2023}}</ref><ref name="Evans 2023"/>
[[Rachel Aviv]], a staff writer at [[The New Yorker|''The New Yorker'']], published a feature article in May 2024 that questioned Letby's conviction.<ref name="TNY">{{Cite news |last=Aviv |first=Rachel |title=A British Nurse Was Found Guilty of Killing Seven Babies. Did She Do It? |work=The New Yorker |date=13 May 2024 |url=https://www.newyorker.com/magazine/2024/05/20/lucy-letby-was-found-guilty-of-killing-seven-babies-did-she-do-it}}</ref> In the article, Aviv highlighted how pervasive staffing shortages at Countess of Chester Hospital's neonatal unit had led to a dramatic increase in poor care outcomes both during and after Letby's tenure, and noted the consistent use of flawed statistical reasoning by prosecutors. In a case of the [[Texas sharpshooter fallacy]], Aviv claimed that prosecutors placed undue weight on events that supported their theory of the case, while discounting contradictory ones. Aviv also questioned the testimony of Dewi Evans, a retired [[consultant paediatrician]] and prosecution witness whose attestations had "laid the medical foundation for the prosecution’s case" despite a report prepared by Evans as an expert witness in a previous case having been deemed "worthless" as well as expressing opinions that were "tendentious and partisan" and "outside Dr. Evans' professional competence" by a Court of Appeals judge.<ref name="TNY" />
Statistician [[Richard D. Gill]] and lawyer Neil Mackenzie KC, who co-authored a work with others on the use of statistics in court cases, have also questioned the outcome.{{r|Steafal 2023}}<ref>{{Cite news |last=Davis |first=Nicola |date=3 October 2023 |title=Experts call for Lucy Letby inquiry to cover statistical evidence used in trial |language=en-GB |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/oct/03/lucy-letby-inquiry-statistical-evidence-used-in-trial |access-date=2023-10-06 |issn=0261-3077}}</ref> Gill has claimed that the trial was based on misleading or misapplied data which heavily implicated Letby, when in fact there are often clusters of deaths in hopsitals.<ref>{{cite web |last=Gill |first=Richard |title=The Timeline of the Conspiracy |date=12 October 2023 |url=https://gill1109.com/2023/10/12/the-timeline-of-the-conspiracy/}}</ref>
====Other reactions====
Dewi Evans has called for an investigation into the possibility of charges of [[corporate manslaughter]] in relation to the Letby case.<ref>{{Cite news |last=Halliday |first=Josh |date=19 August 2023 |title=Lucy Letby: Police urged to investigate hospital bosses for corporate manslaughter |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/19/lucy-letby-police-urged-to-investigate-hospital-bosses-for-corporate-manslaughter |access-date=20 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821022650/https://www.theguardian.com/uk-news/2023/aug/19/lucy-letby-police-urged-to-investigate-hospital-bosses-for-corporate-manslaughter |url-status=live }}</ref>
[[The Royal College of Paediatrics and Child Health]] stated, "We must learn from these crimes and how Lucy Letby was able to bring harm to these babies so that no situation like this can ever happen again" and welcomed the independent inquiry.<ref name=":2">{{cite web |title=RCPCH responds to verdict in Lucy Letby trial |url=https://www.rcpch.ac.uk/news-events/news/rcpch-responds-verdict-lucy-letby-trial |access-date=19 August 2023 |website=RCPCH |archive-date=19 August 2023 |archive-url=https://web.archive.org/web/20230819133710/https://www.rcpch.ac.uk/news-events/news/rcpch-responds-verdict-lucy-letby-trial |url-status=live }}</ref> [[NHS England]]'s Chief Nursing Officer [[Ruth May (nurse)|Dame Ruth May]] issued a statement saying, "The NHS is fully committed to doing everything we can to prevent anything like this ever happening again, and we welcome the independent inquiry announced by the Department of Health and Social Care to help ensure we learn every possible lesson from this awful case."<ref>{{cite web |title=NHS England » Commenting on the verdict in the Lucy Letby trial |url=https://www.england.nhs.uk/2023/08/commenting-on-the-verdict-in-the-lucy-letby-trial/ |access-date=19 August 2023 |website=www.england.nhs.uk |archive-date=19 August 2023 |archive-url=https://web.archive.org/web/20230819133717/https://www.england.nhs.uk/2023/08/commenting-on-the-verdict-in-the-lucy-letby-trial/ |url-status=live }}</ref>
On 21 August 2023, it was announced that the nursing director at the Countess of Chester Hospital at the time Letby was based there had been suspended from her job as a senior nursing officer at [[Northern Care Alliance NHS Foundation Trust]] with immediate effect, because of information that came to light during the trial.<ref name="BBC 66569258"/> The [[Nursing and Midwifery Council]] subsequently announced she would face an investigation into her fitness to practice.<ref>{{cite web |url=https://www.bbc.co.uk/news/uk-england-merseyside-66586463 |title=Lucy Letby: Claims nursing director ignored warnings to be investigated |work=BBC News |date=22 August 2023 |accessdate=22 August 2023 |archive-date=22 August 2023 |archive-url=https://web.archive.org/web/20230822194459/https://www.bbc.co.uk/news/uk-england-merseyside-66586463 |url-status=live }}</ref> She and other executives at the hospital have been accused of ignoring warnings about Letby.<ref name="BBC 66569258">{{cite news |url=https://www.bbc.co.uk/news/uk-66569258 |title=Alison Kelly: Former nursing manager at Letby hospital suspended |work=BBC News |date=21 August 2023 |accessdate=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821190626/https://www.bbc.com/news/uk-66569258 |url-status=live }}</ref>
It was reported that the British government were examining how Letby's pension can be stopped.<ref>{{cite web |title=Child killer Lucy Letby 'to be stripped' of NHS pension after conviction |url=https://www.standard.co.uk/news/politics/killer-lucy-letby-nurse-nhs-pension-steve-barclay-b1102409.html |website=Evening Standard |date=23 August 2023 |access-date=23 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084617/https://www.standard.co.uk/news/politics/killer-lucy-letby-nurse-nhs-pension-steve-barclay-b1102409.html |url-status=live}}</ref> The NHS pension scheme regulations provide for a forfeit of pensions after a conviction of certain crimes.<ref>{{Cite news |date=23 August 2023 |title=Lucy Letby: Killer nurse to be stripped of NHS pension after baby murders |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-nurse-babies-parents-petition-prison-b2397695.html |access-date=23 August 2023 |work=Independent |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084617/https://www.independent.co.uk/news/uk/crime/lucy-letby-prison-parents-latest-news-b2398457.html |url-status=live}}</ref>
The Government announced that it would introduce new powers to compel convicted criminals to attend sentencing hearings.<ref>{{cite news |title=Criminals to be forced to attend sentencing hearings |work=BBC News |date=30 August 2023 |url=https://www.bbc.co.uk/news/uk-66660136 |access-date=30 August 2023 |archive-date=30 August 2023 |archive-url=https://web.archive.org/web/20230830200235/https://www.bbc.co.uk/news/uk-66660136 |url-status=live}}</ref>
==See also==
* [[List of prisoners with whole life orders]]
* [[List of serial killers in the United Kingdom]]
* [[2011 Stepping Hill Hospital poisoning incident]] – [[Saline (medicine)|saline]] poisoning deaths in [[Greater Manchester]], England
* [[Benjamin Geen]] – British nurse convicted in 2006 of murdering two patients
* [[Genene Jones]] – American nurse responsible for the deaths of up to 60 infants and children in her care during the 1970s and 1980s
* [[Colin Norris]] – British nurse convicted of murdering four patients with insulin in 2008
* [[Harold Shipman]] – British [[general practitioner]] convicted in 2000 of 15 murders but suspected of as many as 250
* [[Elizabeth Wettlaufer]] – Canadian nurse who murdered eight senior patients between 2007 and 2016
==References==
{{Reflist|colwidth=30em|refs=<ref name="Panorama">{{cite AV media
| people = [[BBC One]]
| date = 18 August 2023
| title = Panorama, Lucy Letby: The Nurse Who Killed
| trans-title =
| type = TV documentary
| language =
| url = https://www.bbc.co.uk/programmes/m001q7dl
| access-date = 23 August 2023
| archive-url =
| archive-date =
| time =
| location =
| publisher =
| id =
| isbn =
| oclc =
| quote =
}}</ref>}}
{{Authority control}}
{{DEFAULTSORT:Letby, Lucy}}
[[Category:1990 births]]
[[Category:20th-century British women]]
[[Category:21st-century British women]]
[[Category:21st-century British criminals]]
[[Category:Alumni of the University of Chester]]
[[Category:British female serial killers]]
[[Category:British people convicted of attempted murder]]
[[Category:British women nurses]]
[[Category:English murderers of children]]
[[Category:English nurses]]
[[Category:English prisoners sentenced to life imprisonment]]
[[Category:Criminals from Herefordshire]]
[[Category:Living people]]
[[Category:Nurses convicted of killing patients]]
[[Category:People convicted of murder by England and Wales]]
[[Category:People from Hereford]]
[[Category:Prisoners sentenced to life imprisonment by England and Wales]]' |
New page wikitext, after the edit (new_wikitext) | '{{Short description|British serial killer (born 1990)}}
{{Use British English|date=August 2023}}
{{Use dmy dates|date=August 2023}}
{{Primary sources|date=November 2023}}
{{Infobox criminal
| name = Lucy Letby
| occupation = Neonatal nurse
| image = Lucy Letby mugshot.jpg
| caption = Letby following her arrest in 2018
| birth_date = {{Birth date and age|1990|01|04|df=yes}}
| birth_place = [[Hereford]], [[Herefordshire]], England
| country = United Kingdom
| beginyear = 2015
| endyear = 2016
| apprehended = 3 July 2018
| conviction = [[Murder in English law|Murder]] (7 counts), [[attempted murder]] (7 counts)
| charge = Attempted murder (1 count; to go to trial in 2024)
| fatalities = 7
| injuries = 6
| penalty = {{Br separated entries|[[Life imprisonment in England and Wales|Life imprisonment]]|([[whole life order]])}}
| imprisoned = [[HM Prison Bronzefield]] {{asof|January 2024|lc=y}}
}}
'''Lucy Letby''' (born 4 January 1990) is a British former [[neonatal nurse]] who was convicted of murdering seven infants and attempting to murder six others between June 2015 and June 2016. Letby was the focus of suspicion following a high number of [[infant death]]s at the [[neonatal intensive care unit|neonatal unit]] of the [[Countess of Chester Hospital]], shortly after she was qualified to work with children in the hospital's [[intensive care unit]], and owing to her being on duty whenever suspicious incidents took place.
Letby was charged in November 2020 with eight counts of murder and ten counts of [[attempted murder]]. During her trial, which lasted from October 2022 to August 2023, it was revealed that Letby's accused methods included injecting the infants [[air embolism|with air]] or insulin, overfeeding them, and physically abusing them with medical tools. She also removed over 250 confidential nursing handover sheets from her workplace which should never have left the hospital, and she falsified patient records to avert suspicion. Several parents and colleagues of Letby had also entered the room during, or soon after, an attack. On 21 August 2023, Letby was sentenced to [[Life imprisonment in England and Wales|life imprisonment]] with a [[whole life order]]. Letby had pleaded not guilty at her trial and told a subsequent [[Nursing and Midwifery Council]] disciplinary panel that she is innocent. An application to appeal her conviction was renewed in February 2024 and was heard by the [[Court of Appeal (England and Wales)|Court of Appeal]] in April 2024 with judgement reserved to a later date. She also faces a retrial in June 2024 on the single charge on which the jury were unable to reach a verdict in the original trial.
Letby is the most prolific serial killer of children in modern British history; the [[Cheshire Constabulary]] now suspects that she may have claimed more victims, including at [[Liverpool Women's Hospital]], where two infants died during her training. Management at the Countess of Chester Hospital were criticised for ignoring warnings about Letby that could have prevented some of the killings. The [[Government of the United Kingdom|British government]] has commissioned an independent statutory inquiry into the circumstances surrounding the murders.
==Early life and education==
Lucy Letby was born on 4 January 1990 in [[Hereford]], [[Herefordshire]], the only child of a finance manager and an accounts clerk.<ref name=":1">{{Cite news |last1=Ball |first1=Tom |last2=Mitib |first2=Ali |last3=Wace |first3=Charlotte |date=18 August 2023 |title=Who is Lucy Letby? The nurse who became Britain's most prolific child killer |work=The Times |url=https://www.thetimes.co.uk/article/who-is-lucy-letby-nurse-killed-family-babies-background-family-friends-education-s7njrswmc |url-access=subscription |access-date=19 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820205750/https://www.thetimes.co.uk/article/who-is-lucy-letby-nurse-killed-family-babies-background-family-friends-education-s7njrswmc |url-status=live }}</ref> She was educated at [[Aylestone School]] and [[Hereford Sixth Form College]].<ref name=":1" /><ref name="bbc20230818">{{Cite AV media |url=https://www.bbc.co.uk/news/uk-england-merseyside-65058159 |title=Who is baby serial killer Lucy Letby? |date=18 August 2023 |last=Hirst |first=Lauren |access-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818124114/https://www.bbc.co.uk/news/uk-england-merseyside-65058159 |archive-date=18 August 2023 |url-status=live |work=BBC News}}</ref> She had had a very difficult birth herself and was, according to a friend who knew her since secondary school, "very grateful for being alive to the nurses who would have helped save her life".{{R|Panorama|at=18:40}} This, the friend states, had led her to want to be a nurse all her life and that "everything that she did was geared towards that ultimate goal of becoming a nurse".{{R|Panorama|at=18:55}}<ref name="bbc2">{{Cite news |last=Moritz |first=Judith |date=18 August 2023 |title=What I learned about Lucy Letby after 10 months in court |work=BBC News |url=https://www.bbc.com/news/uk-66104004 |access-date=21 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824083632/https://www.bbc.com/news/uk-66104004 |url-status=live }}</ref> Letby pursued her education in nursing at the [[University of Chester]], where she also worked as a student nurse during her three years of training, carrying out placements at [[Liverpool Women's Hospital]] and the [[Countess of Chester Hospital]].<ref name=":1" /><ref name="moreau">{{Cite news |last=Moreau |first=Charlotte |date=19 August 2023 |title=Hereford 'very much home' for serial killer Lucy Letby |work=Hereford Times |url=https://www.herefordtimes.com/news/23733719.hereford-very-much-home-serial-killer-lucy-letby/ |access-date=19 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820185736/https://www.herefordtimes.com/news/23733719.hereford-very-much-home-serial-killer-lucy-letby/ |url-status=live }}</ref> Letby was the first member of her family to study at university and graduated in September 2011.<ref name=":1" />
==Career==
Letby began working as a [[registered nurse]] at the neonatal unit of the Countess of Chester Hospital in 2012.<ref name=Lintern>{{cite news|url=https://www.thetimes.co.uk/article/lucy-letby-files-nurse-hospital-evidence-rkxchgqh9|url-access=subscription|work=The Times |date=19 August 2023|last1=Lintern|first1=Shaun|last2=Collins|first2=David|title=Revealed: the files that show how Lucy Letby was treated as a victim|access-date=19 August 2023|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820190349/https://www.thetimes.co.uk/article/lucy-letby-files-nurse-hospital-evidence-rkxchgqh9|url-status=live}}</ref> In a 2013 staff profile, she said that she was responsible for "caring for a wide range of babies requiring various levels of support" and that she enjoyed "seeing them progress and supporting their families."<ref>{{cite web |date=28 March 2013 |title=Staff Profile – Lucy Letby |url=https://www.coch.nhs.uk/media/74654/chester_standard_babygrow_page_1070kb__28.03.2013_.pdf |access-date=18 August 2023 |archive-date=5 December 2022 |archive-url=https://web.archive.org/web/20221205060026/https://www.coch.nhs.uk/media/74654/chester_standard_babygrow_page_1070kb__28.03.2013_.pdf |url-status=live}}</ref> Letby also took part in a campaign to raise funds for a new neonatal unit at the hospital.<ref name=":0">{{cite news|title=Home searched after baby murder arrest belongs to Chester children's nurse |url=https://www.chesterstandard.co.uk/news/16332233.home-searched-baby-murder-arrest-belongs-chester-childrens-nurse/ |access-date=27 October 2022 |work=The Standard |date=4 July 2018 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027192329/https://www.chesterstandard.co.uk/news/16332233.home-searched-baby-murder-arrest-belongs-chester-childrens-nurse/ |url-status=live }}</ref>
Letby had two training placements at Liverpool Women's Hospital, in late 2012 and early 2015, which came under investigation after her conviction.<ref name="moreau" /> In June 2016, consultants asked management to remove her from clinical duties pending an investigation into her conduct. She had previously been moved from night to day shifts in April 2016 by the unit's ward manager.<ref name="Lintern" /> Letby was transferred to the patient experience team in July 2016 and later to the risk and patient safety office, working there until her arrest in 2018.<ref name="HSJ" />
Letby qualified to work with the infants who needed intensive care in 2015, the same year the suspicious incidents began.<ref name="Intensive2015">{{cite news |last1=Corcoran |first1=Sophie |title=What is the evidence against Lucy Letby? Five key points that convicted baby killer |url=https://www.examinerlive.co.uk/news/uk-world-news/what-evidence-against-lucy-letby-27549159 |access-date=25 August 2023 |work=YorkshireLive |date=18 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824141723/https://www.examinerlive.co.uk/news/uk-world-news/what-evidence-against-lucy-letby-27549159 |url-status=live }}</ref> Letby had told others that she found non-intensive care work "boring".<ref name="boring" /> When she was moved to day shifts the suspicious incidents notably moved from occurring overnight to happening in the daytime when Letby was working.<ref name="CPS"/>
==Murders==
===Initial investigation===
An informal review conducted in June 2015 by a consultant and lead [[neonatologist]] at the Countess of Chester Hospital NHS Foundation Trust revealed troubling details regarding four unexplained collapses that occurred in the same unit. Three of these cases resulted in deaths in the same month. It was observed that Letby had been on shift on each occasion. The unit's consultants promptly reported these deaths to the trust's committee responsible for addressing serious incidents. The committee classified the deaths as "medication errors". Had they been classified as "serious incident[s] involving unexpected deaths", an immediate investigation could have taken place if they were grouped together.<ref name=Lintern/> The numbers of unexplained collapses were particularly abnormal: there had previously been only two or three deaths a year in the neonatal unit. What was also particularly unusual was that the babies did not respond to resuscitation attempts as they would be expected to.{{R|Panorama|at=23:40}} Usually babies that had got a heartbeat back would see an improvement in their breathing, but that did not happen in these cases.{{R|Panorama|at=23:45}} Detective Superintendent Paul Hughes, who later led the investigation,<ref name=Trust/> was told by two medical consultants that baby collapses which occurred during the spike had been unexpected and could not be explained, both of which were not usual with infant collapses in general.<ref name="skynews_202308"/>
In October 2015, a ward manager conducted her own review, noting that Letby was the only staff member consistently present throughout these incidents of unexplained collapses and deaths. These findings were relayed to the lead neonatologist. Further concerns were voiced to management by the unit's consultants that same month; concerns were either resisted by the Trust Executives or ignored.<ref name="HSJ" /><ref name=":3" /> In February 2016, the lead neonatologist, along with other consultants, concluded a thematic review investigating five unexplained deaths and collapses within the unit. Their investigation determined that the only common factor in these cases was the presence of Letby. The lead neonatologist contacted the unit manager, the hospital's medical director and the director of nursing, requesting an urgent meeting.<ref name=":3"/> A meeting took place in May 2016.<ref name=":4" /> The executive team deemed the spike in deaths to be coincidental and no substantial action was taken.<ref name="Lintern" /><ref name=":4">{{cite news|url=https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised|work=The Guardian|title=Timeline of Lucy Letby's attacks on babies and when alarm was raised|date=18 August 2023|accessdate=20 August 2023|last1=Halliday|first1=Josh|last2=Blight|first2=Garry|last3=Fischer|first3=Harry|last4=Kirk|first4=Ashley|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820175554/https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised|url-status=live}}</ref>
Reports by the nationwide [[MBRRACE-UK]] project found a neonatal death rate at least 10% higher than expected between June 2015 and June 2016. Additionally, the neonatal death total in 2015 doubled that of the previous year.<ref>{{cite news|url=http://www.chesterchronicle.co.uk/news/chester-cheshire-news/death-rate-countess-chester-maternity-13227719|title=Death rate at Countess of Chester maternity unit among highest in country|first=Bill|last=Gleeson|date=25 June 2017 |work=CheshireLive |access-date=27 January 2023|archive-date=12 September 2018|archive-url=https://web.archive.org/web/20180912220133/https://www.chesterchronicle.co.uk/news/chester-cheshire-news/death-rate-countess-chester-maternity-13227719|url-status=live}}</ref><ref>{{Cite news|url=https://www.bbc.com/news/uk-england-merseyside-44696813|title=Countess of Chester Hospital: Woman held in baby deaths probe|date=3 July 2018|access-date=27 January 2023 |work=BBC News |archive-date=30 January 2023|archive-url=https://web.archive.org/web/20230130022933/https://www.bbc.com/news/uk-england-merseyside-44696813|url-status=live}}</ref><ref>{{cite news |last1=Matthews-King |first1=Alex |title=Lucy Letby: Newborn deaths doubled at hospital where nurse arrested on suspicion of babies' murders worked |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-baby-murders-newborn-death-rate-name-of-hospital-neo-natal-unit-police-a8433011.html |access-date=20 August 2023 |work=Independent |date=5 July 2018 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820181219/https://www.independent.co.uk/news/uk/crime/lucy-letby-baby-murders-newborn-death-rate-name-of-hospital-neo-natal-unit-police-a8433011.html |url-status=live }}</ref> The mortality rate had risen above what might be considered 'normal' rates.<ref name="Sky evidence" /> During a hospital visit in February 2016, The [[Care Quality Commission]] (CQC) was informed of difficulties in raising concerns with managers, but heard no mention of an elevated mortality rate. The CQC's report identified issues of "short-staffing" and "skill-mix" issues within the unit, yet it praised the overall positive culture of the trust, where "[s]taff felt well supported, able to raise concerns and develop professionally."<ref name="HSJ">{{cite news|url=https://www.hsj.co.uk/countess-of-chester-hospital-nhs-foundation-trust/revealed-how-trust-execs-resisted-concerns-over-letby/7035170.article|work=Health Service Journal|last=Dunhill|first=Lawrence|date=18 August 2023|access-date=19 August 2023|title=Revealed: How trust execs resisted concerns over Letby |url-status=live |archive-url=https://web.archive.org/web/20230819123650/https://www.hsj.co.uk/countess-of-chester-hospital-nhs-foundation-trust/revealed-how-trust-execs-resisted-concerns-over-letby/7035170.article |archive-date=19 August 2023}}</ref>
On 24 June 2016, following the deaths of two triplet babies on that day and the previous day, the lead neonatologist phoned the duty executive demanding that Letby be removed from the unit. The duty executive insisted that Letby was safe to work and that she was "happy to take responsibility" if anything happened to any more babies under Letby's care.<ref name=":4" /><ref name=":3">{{cite news|url=https://www.bbc.com/news/uk-66120934|work=BBC News |title=Hospital bosses ignored months of doctors' warnings about Lucy Letby|date=18 August 2023|accessdate=22 August 2023|last1=Moritz|first1=Judith|last2=Coffey|first2=Jonathan|last3=Buchanan|first3=Michael|archive-date=24 August 2023|archive-url=https://web.archive.org/web/20230824083657/https://www.bbc.com/news/uk-66120934|url-status=live}}</ref> In late June 2016, the trust's executive directors convened to address the question whether to involve law enforcement. By this time, seven unexpected deaths had taken place within the unit. The belief among these executives was that the indications of Letby's involvement were largely circumstantial and they suspected certain doctors of embarking on a misguided "witch hunt". Moreover, they were concerned about potential harm to the Trust's reputation resulting from a police inquiry. Ultimately, they opted against engaging the police.{{R|Lintern}} The medical director and chief executive instead organised a review through the [[Royal College of Paediatrics and Child Health]] (RCPCH), which was initiated in September 2016. The unit's services were scaled back by hospital managers on 7 July 2016, cutting cot space numbers and no longer accommodating premature births before the 32-week mark.<ref name="nursingtimes_20230818">{{cite web|url=https://www.nursingtimes.net/news/children/breaking-lucy-letby-convicted-of-murdering-seven-babies-at-hospital-neonatal-unit-18-08-2023/|title=Lucy Letby convicted of murdering seven babies at hospital neonatal unit|work=[[Nursing Times]]|agency=[[PA Media|The Press Association]]|date=18 August 2023|access-date=15 March 2024}}</ref>
The trust set a narrow scope for the review that excluded investigating Letby's actions or the deaths, but instead focused on the unit's general service. The RCPCH reported their findings to the medical director and chief executive in October 2016.<ref name=Lintern/> They could not find a definitive explanation for the increase in mortality rate at the unit but found some insufficient staffing and senior cover. The report recommended a detailed case review of each death. The medical director asked neonatologist Jane Hawdon from [[Great Ormond Street Hospital]] to carry out the case reviews. Hawdon responded she could not conduct a detailed review because of lack of time but could provide a summary and did so after briefly reviewing the notes. She identified four cases that "potentially benefit from local forensic review as to circumstances, personnel etc".<ref name=Lintern/><ref name=HSJ/><ref name=parveen/> The board's chair at the time has said that he was misled about the scope of that review and its findings.<ref>{{cite news|url=https://www.bbc.co.uk/news/uk-england-merseyside-66553970|title=Lucy Letby: Hospital bosses were misled, former chair claims|work=BBC News|date=19 August 2023|access-date=19 August 2023|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820123721/https://www.bbc.co.uk/news/uk-england-merseyside-66553970|url-status=live}}</ref> Despite the thorough external independent review recommended by the RCPCH or the forensic review recommended by Hawdon, records of the hospital board meeting show the medical director telling board members that the RCPCH and Hawdon reviews concluded that the deaths in the neonatal unit were due to issues with leadership and timely intervention.<ref name=":3" />
In September 2016, Letby raised a formal grievance about her late June 2016 transfer from clinical duties to the hospital's risk and patient safety office.<ref name=":3" /> This grievance was upheld by the board in January 2017, which determined her removal had been "orchestrated by the consultants with no hard evidence". They supported her return to the neonatal unit and offered her a placement at Alder Hey Children's Hospital in [[Liverpool]] plus support to develop advanced practice or a master's degree. The medical director also commented in the report that the trust's intention was to "protect Lucy Letby from these allegations".<ref name=Lintern/><ref name=HSJ/><ref name=Halliday/> The chief executive had met with Letby and her parents on 22 December 2016 to apologise on behalf of the trust and assure them that the doctors who made the allegations would be "dealt with".<ref name=Lintern/> He later ordered the consultants to send a letter of apology to Letby, which they did in February 2017.<ref name=Halliday>{{cite news|url=https://www.theguardian.com/uk-news/2023/aug/19/doctors-were-forced-to-apologise-for-raising-alarm-over-lucy-letby-and-baby-deaths|work=The Guardian|title=Doctors were forced to apologise for raising alarm over Lucy Letby and baby deaths|date=19 August 2023|access-date=19 August 2023|last=Halliday|first=Josh|url-status=live |archive-url=https://web.archive.org/web/20230819063231/https://www.theguardian.com/uk-news/2023/aug/19/doctors-were-forced-to-apologise-for-raising-alarm-over-lucy-letby-and-baby-deaths |archive-date=19 August 2023}}</ref><ref name=Trust>{{cite news|url=https://www.theguardian.com/uk-news/2023/aug/19/trust-me-im-a-nurse-why-wasnt-lucy-letby-stopped-as-months-of-went-by|work=The Guardian|date=19 August 2023|accessdate=19 August 2023|title='Trust me, I'm a nurse': Why wasn't Lucy Letby stopped as months of murder went by?|last=Halliday|first=Josh|archive-date=21 August 2023|archive-url=https://web.archive.org/web/20230821022724/https://www.theguardian.com/uk-news/2023/aug/19/trust-me-im-a-nurse-why-wasnt-lucy-letby-stopped-as-months-of-went-by|url-status=live}}</ref>
In March 2017, consultants asked management to involve the police after receiving advice from the regional neonatal lead, who suggested further investigation was needed.<ref name=HSJ/> They then met with [[Cheshire Constabulary]] on 27 April 2017, to raise their concerns, with Letby due to return to work on 3 May 2017.<ref name=Trust/> The trust publicly announced the involvement of the police in May 2017, stating this move was to "seek assurances that enable us to rule out unnatural causes of death."<ref name=HSJ/><ref name="cochmay17">{{cite web|url=http://www.coch.nhs.uk/corporate-information/news/neonatal-update-thursday-18-may.aspx|title=Neonatal Update – Thursday 18 May|date=18 May 2017|publisher=Countess of Chester NHS Foundation Trust|website=coch.nhs.uk|access-date=5 July 2018|url-status=dead|archive-date=17 June 2017|archive-url=https://web.archive.org/web/20170617153846/http://www.coch.nhs.uk/corporate-information/news/neonatal-update-thursday-18-may.aspx}}</ref> The police's investigation was called Operation Hummingbird.<ref name="guardian_20230820"/> Senior Investigating Officer Paul Hughes later said: "the initial focus was around the hypotheses of what could have occurred: so generic hypotheses of 'it could be natural-occurring deaths', 'it could be natural-occurring collapses', 'it could be an organic reason', 'it could be a virus', and then one of the hypotheses was that, obviously, it could be inflicted harm."<ref name="Sky evidence" />
===Timeline of cases===
The first suspicious case occurred on 8 June 2015.<ref name="Sky evidence" /> At 8 pm a healthy baby boy – a twin – was being cared for in nursery 1 on the ward and the designated nurse was Letby.<ref name="Sky evidence" /><ref name="Guardian timeline">{{cite news |title=Timeline of Lucy Letby's attacks on babies and when alarm was raised |url=https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised#:~:text=Lucy%20Letby%20has%20been%20found,neonatal%20unit%20where%20she%20worked. |first1=Josh|last1=Halliday|first2=Garry|last2=Blight|first3=Harry|last3=Fischer|first4=Ashley|last4=Kirk|access-date=25 August 2023 |work=The Guardian |date=18 August 2015 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820175554/https://www.theguardian.com/uk-news/ng-interactive/2023/aug/18/lucy-letby-timeline-attacks-babies-when-alarm-raised#:~:text=Lucy%20Letby%20has%20been%20found,neonatal%20unit%20where%20she%20worked. |url-status=live }}</ref> The boy had been handed over to Letby after she started her night shift, with the paediatric registrar having clocked off when Letby was 30 minutes into her shift.<ref name="Sky evidence" /><ref name="Guardian timeline"/><ref name="Boy A Guardian">{{cite news |title=Death of baby in Lucy Letby case 'completely out of blue', says witness |url=https://www.theguardian.com/uk-news/2022/oct/19/death-of-baby-in-lucy-letby-case-completely-out-of-blue-says-witness |access-date=25 August 2023 |work=The Guardian |date=19 October 2022 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825133432/https://www.theguardian.com/uk-news/2022/oct/19/death-of-baby-in-lucy-letby-case-completely-out-of-blue-says-witness |url-status=live }}</ref> Twenty-six minutes later, she called a doctor with the baby's state rapidly deteriorating. The baby died half an hour later, less than 90 minutes into Letby's shift.<ref name="Sky evidence" /> The paediatric registrar later testified that when she heard about the death of the child the next day after returning to work that it was a "big surprise" and "completely out of the blue and very upsetting. [He] showed no signs of any problems throughout the day. He was handling well. I had no concerns at all for him or his twin sister".<ref name="Boy A Guardian"/> A fellow nurse said that when the baby started deteriorating she saw Letby standing over the infant's incubator and originally did not intervene. However, the nurse then did when she realised he was not recovering under Letby's care.<ref name="Boy A Guardian"/> Doctors attending the scene said that Child A developed an unusual blue and white mottling on his skin after collapsing, which they said they had never seen before.<ref name="Time-s">{{cite news |title=What did Lucy Letby do? Full timeline of how the trial unfolded |url=https://www.thetimes.co.uk/article/what-did-lucy-letby-do-nurse-trial-evidence-rb662kx07 |access-date=25 August 2023 |work=The Times |date=23 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824160804/https://www.thetimes.co.uk/article/what-did-lucy-letby-do-nurse-trial-evidence-rb662kx07 |url-status=live|url-access=subscription}}</ref> This symptom later occurred in other babies that were believed to have been intentionally injected with air.<ref name="Time-s" /> The day after Child A's death, Letby searched for his parents on [[Facebook]].<ref name="Time-s" />
About 28 hours after Child A's death, his twin sister, Child B, also collapsed and had to be resuscitated.<ref name="Guardian timeline"/> After Child A's death, the parents had spent the day with Child B in the nursery with her, but were persuaded to go and rest before the baby's sudden crash.<ref name="Time-s" /> Tests later showed loops of gas-filled bowel in the child.<ref name="Guardian timeline"/> As a result, it was later concluded that the baby had been injected with air.<ref name="Guardian timeline"/> Letby had fed the baby 25 minutes before her collapse and the child had the same unusual rash on her skin as first seen on Child A hours earlier, indicating that she had also been injected with air.<ref name="Time-s" />
A few days later, Child C, a boy in good condition, died.<ref name="Guardian timeline"/> He suddenly collapsed as soon as another nurse left the nursery.<ref name="Time-s" /> Despite not being the designated nurse for the child, Letby was witnessed standing over his monitor as his alarm sounded when the other nurse came back in.<ref name="Guardian timeline"/><ref name="Time-s" /> Letby's shift leader had already told her to focus on her designated patient and the shift leader later testified that she had to keep pulling her away from the family room as Child C died.<ref name="Time-s" /> His parents later recalled a nurse they believe was Letby brought a ventilator basket in and said, even though their child was not dead, "You've said your goodbyes, do you want me to put him in here?".<ref>{{cite news |title=Lucy Letby: Baby stopped breathing without warning, trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63406551 |access-date=25 August 2023 |work=BBC News |date=26 October 2022 |archive-date=15 June 2023 |archive-url=https://web.archive.org/web/20230615222717/https://www.bbc.co.uk/news/uk-england-merseyside-63406551 |url-status=live }}</ref>
On 22 June 2015, baby girl Child D collapsed three times in the early hours and died.<ref name="Guardian timeline"/> Those who attempted to save the child noticed the girl's skin had been discoloured.<ref name="Guardian timeline"/> A post-mortem X-ray showed a 'striking' line of gas in front of the spine, consistent with air being injected into the bloodstream.<ref name="Spine">{{cite news |title=Lucy Letby trial: Air was injected into baby's blood |url=https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |access-date=25 August 2023 |work=BBC News |date=11 November 2022 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824061847/https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |url-status=live }}</ref> A doctor later testified that such a finding could not be explained by natural causes.<ref>{{cite news |title=Lucy Letby trial: Unusual finding in baby's X-ray, court hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |access-date=25 August 2023 |work=BBC News |date=21 October 2022 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824061847/https://www.bbc.co.uk/news/uk-england-merseyside-63599076 |url-status=live }}</ref> The mother had noted Letby "hovering around" the family hours before the baby collapsed.<ref name="Time-s" />
On 2 July, a doctor raised his concerns over the sudden collapses and deaths.<ref name="Guardian timeline"/> No action was taken against Letby.<ref name="Guardian timeline"/> At about 9{{nbsp}}pm on 3 August, the mother of Child E, who had come to the neonatal unit to give him and twin Child F her expressed breast milk, rushed into the room of Child E, having been alarmed by a scream. She found the child having fresh blood around the mouth and being in extreme distress. Letby, standing near<ref name="near"/> to his incubator, was described by the mother as "not doing anything" in the face of the apparent emergency.{{R|Panorama|at=3:30}} The mother would recount seeing Letby then as someone who "wants to look busy but they're not actually doing anything".{{R|Panorama|at=3:30}} Letby said that the bleeding had merely been from a rubbing feeding tube and asked the mother to calm down.<ref name="near">{{cite web|url=https://www.theguardian.com/uk-news/2023/aug/18/lucy-letby-how-did-a-nurse-commit-such-unthinkable-murders|title=Lucy Letby: how did a nurse commit such unthinkable murders?|first=Josh|last=Halliday|work=The Guardian|date=18 August 2023|access-date=13 October 2023}}</ref> The boy died in the early hours of 4 August after having lost about a quarter of his blood, a "striking" amount according to a blood specialist testifying at court, who agreed with defence that her observations did not help establish a cause of death; injection of air was another suspected reason for the death.<ref name="Guardian timeline"/><ref>{{cite news| title=Lucy Letby: Baby's catastrophic bleed not spontaneous, trial told|first=Daniel|last=O'Donoghue|work=BBC News| date=29 November 2022| url=https://www.bbc.co.uk/news/uk-england-merseyside-63798909| access-date=30 August 2023| archive-date=24 January 2023| archive-url=https://web.archive.org/web/20230124133256/https://www.bbc.co.uk/news/uk-england-merseyside-63798909| url-status=live}}</ref> Flecks of blood were found in his vomit.<ref>{{cite news |title=Lucy Letby: Baby developed strange purple patches, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-63666826 |access-date=25 August 2023 |work=BBC News |date=17 November 2022 |archive-date=3 December 2022 |archive-url=https://web.archive.org/web/20221203023500/https://www.bbc.co.uk/news/uk-england-merseyside-63666826 |url-status=live }}</ref> No post-mortem was carried out.<ref name="bbc_20221116">{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-63651095|title=Lucy Letby trial: Consultant tells of baby post-mortem decision regret|first=Tom|last=Mullen|work=BBC News|date=16 November 2022|access-date=15 October 2023}}</ref> The next evening, Child E's twin brother Child F was being cared for in nursery 2, the same room in which Letby was looking after another infant.<ref name="Sky evidence" /><ref name="Guardian timeline"/> At 1:54 am Child F suffered an unexpected drop in his blood sugar and saw a surge in his heart rate.<ref name="Sky evidence" /> The child survived and a blood test later revealed that he had been given an "extremely high" amount of exogenous pharmaceutical insulin, which he had never needed.<ref name="Sky evidence" /><ref name="Guardian timeline"/> Later, at trial, Letby did not contest that the baby had been intentionally injected with insulin, suggesting someone else must have done it.<ref name="Time-s" /> Letby searched for the parents of Child E and F on social media in the following weeks and months, and for other parents who were not part of the case.<ref name="Christmas">{{cite news |title=Lucy Letby trial: Mum walked in on nurse killing baby, trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63214073 |access-date=25 August 2023 |work=BBC News |date=11 October 2022 |archive-date=7 June 2023 |archive-url=https://web.archive.org/web/20230607075344/https://www.bbc.co.uk/news/uk-england-merseyside-63214073 |url-status=live }}</ref><ref name="face">{{cite news |title=Lucy Letby trial: Mother found baby with blood on face, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63624914 |first=Daniel |last=O'Donoghue |access-date=25 August 2023 |work=BBC News |date=14 November 2022 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215106/https://www.bbc.co.uk/news/uk-england-merseyside-63624914 |url-status=live }}</ref>
On 7 September 2015, Child G, on her 100th day of being alive, collapsed for the first of three times in the following three weeks.<ref name="Guardian timeline"/> After the first collapse, the baby girl was taken to [[Arrowe Park Hospital]], but five days later she collapsed again, 15 minutes after Letby had been feeding her.<ref name="Guardian timeline"/> The child survived, but is now severely disabled as a result of what happened to her.<ref name="Guardian timeline"/> The baby was witnessed projectile vomiting so massively that it reached the chair next to the cot and canopy.<ref name="Vomit">{{cite news |title=Lucy Letby: No natural cause for baby's vomiting, doctor tells trial |url=https://www.bbc.co.uk/news/uk-england-merseyside-63947039 |access-date=25 August 2023 |work=BBC News |date=12 December 2022 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824061859/https://www.bbc.co.uk/news/uk-england-merseyside-63947039 |url-status=live }}</ref> Her heart rate and oxygen levels also dropped to unusually low levels.<ref name="Vomit" /> Later, at trial, an expert witness doctor concluded that the only viable explanation for the baby vomiting so extraordinarily was if she had received far more milk than that allocated down her feeding tube and that this could not happen accidentally.<ref name="Vomit" /> It was later discovered that Letby had deliberately altered the baby's temperature on her observation chart to make it seem like she was already unwell before she collapsed, and also falsified the time of the baby's collapse to make it seem like it coincided with when a colleague gave the baby a milk feed.<ref name="Time-s" /> A nurse noticed when she arrived after Letby's cry for help after one of the baby girl's collapses that the machine connected to the baby to measure its oxygen saturations and heart rate levels had been turned off.<ref name="Time-s" /> The nurse stated in court that two doctors had apologized to her for not having the machine switched back on after fitting a [[cannula]] to the baby girl. One of the doctors concerned told the court that he did not remember the apology but considered it possible that it had taken place. He agreed that leaving the monitor switched off was "not normal protocol" and possibly a result of his having to rush to another emergency.<ref>{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-63975758|title=Lucy Letby: Doctor cannot recall baby monitor error, trial told |first=Daniel |last=O'Donoghue |work=BBC News |date=14 December 2022 |access-date=7 October 2023}}</ref> A colleague had also noticed that Child G's initial collapse occurred on the day she was originally due to be born.<ref>{{cite news |title=Lucy Letby: Mum praised nurse on day of alleged murder attempt, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63962066 |first=Daniel |last=O'Donoghue |access-date=25 August 2023 |work=BBC News |date=13 December 2022 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215113/https://www.bbc.co.uk/news/uk-england-merseyside-63962066 |url-status=live }}</ref>
About six weeks after Child G's multiple collapses, on 23 October 2015, Child I died.<ref name="Guardian timeline"/> This was the fourth time the baby girl had collapsed.<ref name="Guardian timeline"/> On the fourth collapse, Letby was found next to her incubator by another nurse.<ref name="Light"/> Letby later sent a sympathy card to the baby girl's parents on the day of her funeral, a card which Letby kept photos of on her phone.<ref name="Guardian timeline"/><ref name="Sky evidence" /><ref name="Five key"/> Letby also wanted to go to the funeral.<ref>{{cite news |title=Lucy Letby trial: Accused nurse wanted to attend baby's funeral |url=https://www.bbc.co.uk/news/uk-england-merseyside-65390543 |access-date=25 August 2023 |work=BBC News |date=25 April 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215250/https://www.bbc.co.uk/news/uk-england-merseyside-65390543 |url-status=live }}</ref> Twice the baby was found to have excess air in her stomach which had affected her breathing.<ref name="Light"/> Before the second collapse, Letby had said to a colleague that Child I 'looked pale', even though it would have been hard to see from where they were standing in a doorway looking into the darkened nursery.<ref name="Time-s" /> Then, when the designated nurse for the child turned the light on, she saw the girl was not breathing.<ref name="Light">{{cite news |title=Lucy Letby trial: Nurse killed baby and sent parents card, trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63228147 |access-date=25 August 2023 |work=BBC News |date=12 October 2022 |archive-date=7 June 2023 |archive-url=https://web.archive.org/web/20230607075320/https://www.bbc.co.uk/news/uk-england-merseyside-63228147 |url-status=live |url-access=subscription}}</ref> The child's mother later said Letby 'smiled' as she bathed her dead daughter and offered to take photos of the dead child.<ref name="Time-s" /><ref name="Smiling">{{cite news |title=Lucy Letby: Nurse murdered baby on fourth attempt, court told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64402636 |first=Lauren |last=Hirst |access-date=25 August 2023 |work=BBC News |date=10 February 2023 |archive-date=26 August 2023 |archive-url=https://web.archive.org/web/20230826005845/https://www.bbc.co.uk/news/uk-england-merseyside-64402636 |url-status=live }}</ref> A doctor had seen unusual skin mottling on Child I's skin and X-rays showed the child had a massively enlarged stomach that was consistent with her having been deliberately injected with air.<ref>{{cite news |title=Lucy Letby: Baby had unusual skin mottling, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-64492832 |access-date=25 August 2023 |work=BBC News |date=1 February 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825052736/https://www.bbc.co.uk/news/uk-england-merseyside-64492832 |url-status=live }}</ref><ref>{{cite news |title=Lucy Letby trial: Expert believes baby was given lethal air injection |url=https://www.bbc.co.uk/news/uk-england-merseyside-64516659 |access-date=25 August 2023 |work=BBC News |date=3 February 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825052708/https://www.bbc.co.uk/news/uk-england-merseyside-64516659 |url-status=live }}</ref> Letby later searched for Child I's mother on Facebook.<ref name="Smiling"/>
Later on 23 October, the hospital management was alerted to the concerns of the doctors on the unit.<ref name="Guardian timeline"/> They were told to "not make a fuss".<ref name="Guardian timeline"/> Staff reviews were carried out which highlighted that Letby was always on duty for the suspicious incidents and in February 2016 a doctor requested an "urgent" meeting with executives, but no meeting occurred until May 2016.<ref name="Guardian timeline"/>
By April 2016, Letby had been moved to day shifts because of the concerns about her and the suspicious collapses began occurring in the daytime.<ref name="Time-s" /> On 9 April 2016, two twin brothers suffered sudden collapses within hours of each other.<ref name="Guardian timeline"/> Tests found that Child L had insulin levels in his blood "at the very top of the scale that the equipment was capable of measuring".<ref name="Guardian timeline"/> Hours later, twin brother Child M's heart rate and breathing suddenly dropped and he nearly died.<ref name="Guardian timeline"/> Experts said that Child M's heart problems were likely to have been caused by air being injected into his bloodstream.<ref name="Channel 4">{{cite AV media
| people = [[Channel 4 (UK)]]
| date = 19 August 2023
| title = Lucy Letby: the full story of the serial killer nurse
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}}</ref>{{R|Channel 4|at=3:00}} Although he lived, the child suffers from brain damage.<ref name="Guardian timeline"/> It was noted that the collapses of Child L and M occurred in almost identical circumstances to Child E and F.<ref name="Time-s" /> Both were twins where one was believed to have been injected with insulin and the other with air.<ref name="Time-s" /> Child F had survived his injection of insulin and it was noted that Child L had been injected with twice the dose of insulin, the suggestion being that Letby had done so to ensure death on this occasion.<ref name="Time-s" />
A meeting about the suspicious cases took place on 11 May 2016, but no action was taken.<ref name="Guardian timeline"/>
A month later, Child N nearly died after suffering trauma to the throat.<ref name="Guardian timeline"/> Doctors saw blood and "unusual" swelling at the back of his throat upon examination.<ref name="Child N">{{cite news |title=Doctors saw blood in baby's throat, nurse trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64863527 |access-date=25 August 2023 |work=BBC News |date=6 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214801/https://www.bbc.co.uk/news/uk-england-merseyside-64863527 |url-status=live }}</ref> The baby had been heard randomly "screaming", the jury was told.<ref>{{cite news |title=Lucy Letby: Baby was heard screaming before collapse, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64880004 |first=Daniel |last=O'Donoghue| access-date=25 August 2023 |work=BBC News |date=7 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215131/https://www.bbc.co.uk/news/uk-england-merseyside-64880004 |url-status=live }}</ref> Child N's father said he then saw blood spattered around his son's mouth.<ref>{{cite news |title=Lucy Letby: Dad found baby spattered in blood, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-64825649 |access-date=25 August 2023 |work=BBC News |date=2 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214801/https://www.bbc.co.uk/news/uk-england-merseyside-64825649 |url-status=live }}</ref>
The final two cases occurred within hours of each other on 23 and 24 June 2016.<ref name="Guardian timeline"/> The two children involved were triplets, siblings of each other, and the cases occurred on Letby's first shift back after a holiday in [[Ibiza]].<ref name="Time-s" /><ref name="Guardian timeline"/><ref>{{cite news |title=Lucy Letby: Babies died within 72 hours of nurse's text, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-65844522 |access-date=25 August 2023 |work=BBC News |date=8 June 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215200/https://www.bbc.co.uk/news/uk-england-merseyside-65844522 |url-status=live }}</ref> Child O, a "perfect" healthy baby, was due to be discharged home, but suddenly collapsed on 23 June.<ref name="Guardian timeline"/> When the child initially became unwell, another nurse suggested he be moved to nursery 1 where the sickest children were treated, but Letby disagreed and the baby subsequently collapsed less than two hours later.<ref name="Sky evidence" /> He recovered, but suffered two further collapses and died almost exactly three hours later.<ref name="Sky evidence" /> The lead consultant noted that the child "should have responded better" to resuscitation.<ref name="Sky evidence" /> X-rays on a post-mortem showed he had an abnormal amount of gas in his body and liver damage that an independent pathologist later ruled had resulted from an "impact injury" similar to what would be seen in a car crash.<ref name="Time-s" /><ref name="Guardian timeline"/> 13 minutes after Child O's death, Letby was feeding his triplet brother Child P, who also was expected to be able to soon go home, but he collapsed after his diaphragm was somehow shattered.<ref name="Guardian timeline"/>{{R|Channel 4|at=4:40}} Doctors believed he would make a full recovery. As they prepared him to go to another hospital, Letby said: "He's not leaving here alive, is he?".<ref name="Guardian timeline"/> The boy soon died.<ref name="Guardian timeline"/> X-rays likewise showed an inexplicable amount of gas inside the baby.<ref name="Hawk">{{cite news |title=Lucy Letby: Unusual amount of gas in baby, trial hears |url=https://www.bbc.co.uk/news/uk-england-merseyside-64984212 |access-date=25 August 2023 |work=BBC News |date=16 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214820/https://www.bbc.co.uk/news/uk-england-merseyside-64984212 |url-status=live }}</ref> These deaths have been described as "exceptional" and the "tipping point" when the consultants realised that "drastic" action needed to be taken.{{R|Channel 4|at=4:40}}{{R|Channel 4|at=12:35}} A consultant allowed the surviving triplet to be taken to a different hospital by medics who had turned up to take Child P.<ref name="Time-s" /> The consultant said she allowed this after her parents begged for it, as she now felt Letby was a "mortal danger" to the surviving triplet.<ref name="Time-s" /> Before the second triplet died, Letby had texted a doctor saying she would "be watching them both [Child P and the surviving triplet] like a hawk" and said "I'm OK. Just don't want to be here really. Hoping I may get the new admissions".<ref name="Hawk"/>
Towards the end of June 2016, Letby was removed from the neo-natal ward{{R|Panorama|at=29:00}} and instead moved to a clerical role within the hospital,<ref>{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-65040718|title=Lucy Letby: Doctors resisted nurse's frontline return, trial hears|first=Daniel|last=O'Donoghue|work=BBC News|date=22 March 2023|access-date=14 October 2023}}</ref> and the suspicious collapses stopped.{{R|Panorama|at=29:00}}
===Prosecutions, trials and convictions===
====Arrest and charges====
On 3 July 2018, Letby was arrested by police on suspicion of eight counts of murder and six counts of attempted murder, following a year-long investigation.<ref name="bbc">{{cite news |date=4 July 2018 |title=Nurse Lucy Letby arrested over Chester Hospital baby deaths |url=https://www.bbc.co.uk/news/uk-england-merseyside-44709766 |access-date=5 July 2018 |work=[[BBC News]] |archive-date=5 July 2018 |archive-url=https://web.archive.org/web/20180705051804/https://www.bbc.co.uk/news/uk-england-merseyside-44709766 |url-status=live}}</ref> Letby's home at Chester was searched by police following her arrest.<ref>{{Cite news |last=Powell |first=Tom |date=4 July 2018 |title=Nurse's home searched by police following baby murder arrests |url=https://www.standard.co.uk/news/crime/police-search-home-of-nurse-lucy-letby-after-healthcare-worker-arrested-on-suspicion-of-murdering-eight-babies-at-chester-hospital-a3878676.html |access-date=28 October 2022 |work=Evening Standard |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028125901/https://www.standard.co.uk/news/crime/police-search-home-of-nurse-lucy-letby-after-healthcare-worker-arrested-on-suspicion-of-murdering-eight-babies-at-chester-hospital-a3878676.html |url-status=live }}</ref> After Letby's arrest the investigation was widened to include Liverpool Women's Hospital, another location at which Letby had worked. Police have begun looking into Letby's entire career, including at Liverpool Women's Hospital, since her conviction.<ref name="parveen">{{cite news |last1=Parveen |first1=Nazia |last2=Halliday |first2=Josh |date=4 July 2018 |title=Cheshire baby deaths: police widen inquiry to second hospital |work=[[The Guardian]] |url=https://www.theguardian.com/uk-news/2018/jul/04/cheshire-baby-deaths-nurse-questioned-suspicion-murder-lucy-letby |access-date=5 July 2018 |archive-date=4 July 2018 |archive-url=https://web.archive.org/web/20180704163609/https://www.theguardian.com/uk-news/2018/jul/04/cheshire-baby-deaths-nurse-questioned-suspicion-murder-lucy-letby |url-status=live }}</ref><ref name="skynews_202308">{{Cite news |title=How the police caught Lucy Letby |url=https://news.sky.com/story/how-the-police-caught-lucy-letby-12933640 |first1=Megan|last1=Harwood-Baynes|first2=Tom|last2=Parmenter|access-date=18 August 2023 |work=Sky News |archive-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818203022/https://news.sky.com/story/how-the-police-caught-lucy-letby-12933640 |url-status=live }}</ref><ref>{{Cite news |last=Humphries |first=Jonathan |date=4 July 2018 |title=Lucy Letby's training hospital helping police with baby death probe |url=https://www.chesterchronicle.co.uk/news/chester-cheshire-news/nurse-lucy-letby-trained-liverpool-14866135 |access-date=30 October 2022 |work=CheshireLive |archive-date=11 September 2018 |archive-url=https://web.archive.org/web/20180911172511/https://www.chesterchronicle.co.uk/news/chester-cheshire-news/nurse-lucy-letby-trained-liverpool-14866135 |url-status=live }}</ref>
Letby was bailed on 6 July 2018 as the police continued their inquiries.<ref name="6julyupdate">{{cite web |date=6 July 2018 |title=Update on Countess of Chester Hospital neonatal unit investigation |url=https://www.cheshire.police.uk/news-and-appeals/news/update-on-countess-of-chester-hospital-neonatal-unit-investigation/ |url-status=dead |archive-url=https://web.archive.org/web/20190226112746/https://www.cheshire.police.uk/news-and-appeals/news/update-on-countess-of-chester-hospital-neonatal-unit-investigation/ |archive-date=26 February 2019 |access-date=13 July 2018 |website=cheshire.police.uk |publisher=[[Cheshire Constabulary]]}}</ref> She was rearrested on 10 June 2019 on suspicion of eight cases of murder and nine cases of attempted murder in relation to the cases described above, and released on bail on 13 June.<ref>{{cite web|url=https://www.theguardian.com/uk-news/2019/jun/13/nurse-lucy-letby-released-on-bail-in-chester-baby-deaths-inquiry|title=Nurse released on bail in Chester baby deaths inquiry|agency=[[PA Media|Press Association]]|work=The Guardian|date=13 June 2019|access-date=14 October 2023}}</ref> She was arrested again on 10 November 2020.<ref name="bbc2020">{{cite news |date=10 November 2020 |title=Chester hospital baby deaths probe: Nurse Lucy Letby rearrested |url=https://www.bbc.co.uk/news/uk-england-merseyside-54886213 |work=BBC News |access-date=25 October 2022 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027035241/https://www.bbc.co.uk/news/uk-england-merseyside-54886213 |url-status=live }}</ref><ref name="Guardian_11Nov2020">{{cite news |date=11 November 2020 |title=Nurse Lucy Letby charged with murder after Chester hospital baby deaths |work=The Guardian |agency=PA Media |url=https://www.theguardian.com/uk-news/2020/nov/11/nurse-lucy-letby-charged-with-murder-over-chester-hospital-baby-deaths |access-date=25 October 2022 |archive-date=15 October 2022 |archive-url=https://web.archive.org/web/20221015090403/https://www.theguardian.com/uk-news/2020/nov/11/nurse-lucy-letby-charged-with-murder-over-chester-hospital-baby-deaths |url-status=live }}</ref> There were thousands of exhibits in the investigation, 16,571 of which were not even used as evidence and some of the items were themselves thousands of pages long.<ref name="CC documentary">{{cite AV media
| people = [[Cheshire Police]]
| date = 23 August 2023
| title = Operation Hummingbird: The investigation behind the conviction of Lucy Letby
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}}</ref>{{R|CC documentary|at=37:30}} The 2019 arrest and bailing had been made as by this time three further cases of attempted murder had been identified which investigators needed to question Letby further on and as Letby had been found to have written extensively about the case on her 2018 arrest, detectives wished to see whether she had written anything further in the year while she was under investigation.{{R|CC documentary|at=21:30}}
On 13 March 2020, Letby was placed on an interim suspension by the [[Nursing and Midwifery Council]].<ref>[https://www.nmc.org.uk/globalassets/sitedocuments/ftpoutcomes/2023/march-2023/reasons-letby-icio-67757-20230313.pdf Nursing and Midwifery Council Investigating Committee] {{Webarchive|url=https://web.archive.org/web/20230818192036/https://www.nmc.org.uk/globalassets/sitedocuments/ftpoutcomes/2023/march-2023/reasons-letby-icio-67757-20230313.pdf |date=18 August 2023 }} nmc.org. Retrieved 21 August 2023.</ref>
On 11 November 2020, Letby was charged with eight counts of murder and 10 counts of attempted murder.<ref name="Guardian_11Nov2020" /> She was denied bail and remanded in police custody.<ref>{{cite news |last1=Goddard |first1=Ben |date=13 November 2020 |title=Hereford Nurse Lucy Letby Refused Bail |work=Hereford Times |url=https://www.herefordtimes.com/news/18871228.nurse-accused-murdering-eight-babies-appears-court/ |access-date=18 November 2022 |archive-date=18 November 2022 |archive-url=https://web.archive.org/web/20221118002328/https://www.herefordtimes.com/news/18871228.nurse-accused-murdering-eight-babies-appears-court/ |url-status=live }}</ref> The [[Crown Prosecution Service]] were convinced to approve all of the charges Cheshire Constabulary requested against Letby after it reviewed the evidence the force collected against her.{{R|CC documentary|at=30:30}} Letby denied all charges against her, and pointed to issues of hospital hygiene and staffing levels.<ref>{{cite web|url=https://www.bbc.com/news/uk-england-merseyside-65960506|title=Lucy Letby: Jury retires in trial of nurse accused of baby murders|first=Daniel|last=O'Donoghue|work=[[BBC News]]|date=10 July 2023|access-date=27 February 2024}}</ref>
On 18 August 2023, [[Andrea Sutcliffe]], Chief Executive and Registrar of the Nursing and Midwifery Council, stated that Letby "remains suspended from our register, and we will now move forward with our regulatory action, seeking to strike her off the register".<ref>{{cite web|url=https://www.nmc.org.uk/news/news-and-updates/nmc-responds-to-verdict-in-lucy-letby-trial/|title=NMC responds to verdict in Lucy Letby trial - The Nursing and Midwifery Council|website=www.nmc.org.uk|accessdate=21 August 2023|archive-date=21 August 2023|archive-url=https://web.archive.org/web/20230821190623/https://www.nmc.org.uk/news/news-and-updates/nmc-responds-to-verdict-in-lucy-letby-trial/|url-status=live}}</ref>
====2023 trial====
Letby's trial began at [[Manchester Crown Court (Crown Square)|Manchester Crown Court]] on 10 October 2022 before [[James Goss (judge)|Mr Justice Goss]].<ref>{{Cite news |last=McIntyre |first=Alex |date=30 September 2022 |title=Lucy Letby trial to begin as nurse denies murdering babies at Chester Hospital |url=https://www.cheshire-live.co.uk/news/chester-cheshire-news/lucy-letby-trial-set-begin-25147312 |access-date=28 October 2022 |work=CheshireLive |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028155256/https://www.cheshire-live.co.uk/news/chester-cheshire-news/lucy-letby-trial-set-begin-25147312 |url-status=live }}</ref><ref>{{cite news |last1=Halliday |first1=Josh |date=12 October 2022 |title=Doctor interrupted nurse Lucy Letby's attempt to kill newborn baby, court told |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/12/lucy-letby-mother-bathed-baby-court |access-date=13 October 2022 |archive-date=12 October 2022 |archive-url=https://web.archive.org/web/20221012225319/https://www.theguardian.com/uk-news/2022/oct/12/lucy-letby-mother-bathed-baby-court |url-status=live }}</ref> She pleaded not guilty to seven counts of murder and 15 counts of attempted murder.<ref name="Halliday-2022-10-10">{{cite news |last1=Halliday |first1=Josh |date=10 October 2022 |title=Lucy Letby was 'constant malevolent' presence on neonatal ward, court hears |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/10/lucy-letby-constant-malevolent-presence-neonatal-ward-court-hears |access-date=13 October 2022 |archive-date=12 October 2022 |archive-url=https://web.archive.org/web/20221012185735/https://www.theguardian.com/uk-news/2022/oct/10/lucy-letby-constant-malevolent-presence-neonatal-ward-court-hears |url-status=live}}</ref> Letby's parents and the families of the victims attended the trial.<ref>{{Cite news |title=Lucy Letby's parents arrive at court |newspaper=Yahoo News |date=26 October 2022 |agency=ITN |url=https://uk.news.yahoo.com/lucy-letbys-parents-arrive-court-121820117.html |access-date=28 October 2022 |via=uk.news.yahoo.com |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145714/https://uk.news.yahoo.com/lucy-letbys-parents-arrive-court-121820117.html |url-status=live }}</ref><ref>{{Cite news|title=Latest updates: Hereford nurse Lucy Letby goes on trial accused of baby murders |url=https://www.herefordtimes.com/news/23017427.lucy-letby-hereford-nurse-goes-trial-accused-baby-murders/ |access-date=28 October 2022 |work=Hereford Times |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145714/https://www.herefordtimes.com/news/23017427.lucy-letby-hereford-nurse-goes-trial-accused-baby-murders/ |url-status=live }}</ref>
The child victims were referred to as Child A to Child Q.<ref>{{cite news |date=14 October 2022 |title=Who are the children alleged to have been murdered by Lucy Letby? |url=https://www.itv.com/news/granada/2022-10-14/who-are-the-children-alleged-to-have-been-murdered-by-lucy-letby |access-date=28 October 2022 |work=ITV News |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028125900/https://www.itv.com/news/granada/2022-10-14/who-are-the-children-alleged-to-have-been-murdered-by-lucy-letby |url-status=live}}</ref> The press secrecy around the identities of the 17 babies and nine colleagues who gave evidence was "rarely seen outside proceedings involving matters of national security."<ref name="Pidd 20230818">{{cite news |last1=Pidd |first1=Helen |title=Lucy Letby trial: why the babies remain anonymous |url=https://www.theguardian.com/uk-news/2023/aug/18/lucy-letby-trial-why-babies-remain-anonymous |access-date=18 August 2023 |work=The Guardian |date=18 August 2023 |archive-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818153702/https://www.theguardian.com/uk-news/2023/aug/18/lucy-letby-trial-why-babies-remain-anonymous |url-status=live }}</ref> Two years before the criminal trial, [[Karen Steyn|Mrs Justice Steyn]] banned the identification of the living victims until their 18th birthdays. Parents wanted their identifying information to be protected, though Steyn ruled that one parent's profession as a physician was relevant because of his medical expertise and that it would not make that parent identifiable to the public. Several witnesses requested anonymity, including a doctor with whom Letby was said to be infatuated. The judge approved these requests, ruling that getting testimony from the colleagues was more important than them being publicly identifiable.<ref name="Pidd 20230818" />
The prosecutor said that Letby was a "constant malevolent presence" in the hospital's neonatal unit.<ref name="Halliday-2022-10-10"/> There were witnesses that had apparently walked in during, or just after, Letby's attacks. A mother of one of the victims said she had walked in on Letby trying to kill her baby, with Letby saying "Trust me, I'm a nurse" when interrupted.<ref>{{Cite news |date=11 October 2022 |title=Mother walked in on nurse Lucy Letby trying to kill baby, court told |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/11/lucy-letby-mother-walked-in-nurse-trying-kill-baby-court-told |access-date=28 October 2022 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145704/https://www.theguardian.com/uk-news/2022/oct/11/lucy-letby-mother-walked-in-nurse-trying-kill-baby-court-told |url-status=live }}</ref> Another mother had walked in hearing her baby screaming, to find her child had blood around his mouth with Letby in the room.{{R|Panorama|at=3:30}} Letby told the mother to go back to the ward.{{R|Panorama|at=4:35}} The baby's condition soon worsened and it later died in its parents' arms.{{R|Panorama|at=5:15}} The senior medical consultant who had not recommended a post-mortem examination at the time said later in court that she regretted her decision, which she said she had taken with a view to avoiding any further distress to the parents, who had expressed they were "not keen" to have a post-mortem carried out.<ref name="bbc_20221116"/> Afterwards, Letby bathed the deceased baby in front of her parents.{{R|Panorama|at=6:50}} Another mother of a baby, who had died in October 2015, recounted an uncomfortable experience of Letby bathing her child, recounting: "Lucy Letby and another nurse asked me if I wanted to bathe my baby. While we were bathing her, Lucy came back in. She was smiling and kept going on about how she was present at the first bath and how our daughter had loved it. I wished that she would just stop talking".{{R|Panorama|at=13:30}} Letby's apparent obsession with this baby and her family later continued; she sent a sympathy card to the parents after the baby's death on the day of its funeral.{{R|Panorama|at=13:55}}{{R|ITV|at=16:25}} Upon Letby's arrest it was found on her phone that she had photographed the card before she sent it and had still kept pictures of it.<ref name="Sky evidence" /><ref name="Five key">{{cite news |last1=Patrick |first1=Holly |title=Lucy Letby: Five key pieces of evidence presented during trial of nurse accused of murdering babies on hospital ward |url=https://www.independent.co.uk/tv/news/lucy-letby-trial-murder-evidence-b2386911.html |access-date=25 August 2023 |work=The Independent |date=19 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824143658/https://www.independent.co.uk/tv/news/lucy-letby-trial-murder-evidence-b2386911.html |url-status=live }}</ref>
In a text message sent to a friend on 9 April 2016 two hours after the collapse of Child M, Letby wrote: "Work has been shit but... I have just won £135 on [[Grand National]]!! [horse emoji]." and, in a group chat after the winning bet: "Unpacking party sounds good to me with my flavoured vodka ha ha."<ref>{{cite web|url=https://www.theguardian.com/uk-news/2023/feb/15/lucy-letby-nurse-accused-of-killing-babies-entered-grand-national-on-day-of-attempted|title=Lucy Letby: nurse won Grand National bet on day of attempted baby murders, court told|first=Josh|last=Halliday|work=The Guardian|date=15 February 2023|access-date=29 September 2023}}</ref> On the afternoon of 22 June 2016, following a holiday in [[Ibiza]], she texted a friend: "Probably be back in with a bang lol". Child O died the next day.<ref>{{cite web|url=https://news.sky.com/story/lucy-letby-trial-nurse-completely-out-of-control-after-holiday-court-hears-12906393|title=Lucy Letby trial: Nurse 'completely out of control' after holiday, court hears|first=Samuel|last=Osborne|work=[[Sky News]]|date=20 June 2023|access-date=5 October 2023}}</ref><ref>{{cite web|url=https://www.theguardian.com/uk-news/2023/may/16/lucy-letby-tells-court-killing-babies-was-not-on-her-mind-before-holiday|title=Lucy Letby tells court 'killing babies' was not on her mind before holiday|first=Nadeem|last=Badshah|work=[[The Guardian]]|date=16 May 2023|access-date=5 October 2023}}</ref> The texts were seen as important by the Crown Prosecution Service as it saw them in some instances as appearing to be similar to a live blogging of events.<ref name="CPS">{{cite web |title=Lucy Letby found guilty of baby murders |url=https://www.cps.gov.uk/mersey-cheshire/news/lucy-letby-found-guilty-baby-murders |website=Crown Prosecution Service (CPS) |access-date=25 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825231327/https://www.cps.gov.uk/mersey-cheshire/news/lucy-letby-found-guilty-baby-murders |url-status=live }}</ref> Letby had also told a colleague that taking Child A to the mortuary was "the hardest thing she ever had to do".<ref>{{Cite news |date=27 October 2022 |title=Lucy Letby trial: nurse described newborns' deaths as 'sad and cruel' |work=The Guardian |url=https://www.theguardian.com/uk-news/2022/oct/27/lucy-letby-trial-nurse-described-newborns-deaths-as-sad-and-cruel |access-date=28 October 2022 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027232242/https://www.theguardian.com/uk-news/2022/oct/27/lucy-letby-trial-nurse-described-newborns-deaths-as-sad-and-cruel |url-status=live }}</ref><ref>{{Cite news |title=Accused nurse Lucy Letby told colleague that taking first alleged murder victim to mortuary was hardest thing she'd ever had to do, court hears |url=https://news.sky.com/story/accused-nurse-lucy-letby-told-colleague-that-taking-first-alleged-murder-victim-to-mortuary-was-hardest-thing-shed-ever-had-to-do-court-hears-12723849 |access-date=28 October 2022 |work=Sky News |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145703/https://news.sky.com/story/accused-nurse-lucy-letby-told-colleague-that-taking-first-alleged-murder-victim-to-mortuary-was-hardest-thing-shed-ever-had-to-do-court-hears-12723849 |url-status=live }}</ref> Letby had also searched for the parents of several infant victims on Facebook, in one case on the anniversary of a baby's death.{{R|Panorama|at=45:40}}<ref>{{Cite news |date=19 October 2022 |title=Lucy Letby: Nurse searched for parents on Facebook, jury told |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63315104 |access-date=28 October 2022 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145713/https://www.bbc.com/news/uk-england-merseyside-63315104 |url-status=live}}</ref> In total Letby had searched for 11 of the families affected.<ref name="Sky evidence" /> When police had asked her why she had searched up the parents of Child O on the anniversary of its death, she had responded that she "could not explain why she would be doing it".<ref>{{cite news |title=Lucy Letby: Baby triplet died after trauma to liver, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-64965091 |access-date=25 August 2023 |work=BBC News |date=15 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214801/https://www.bbc.co.uk/news/uk-england-merseyside-64965091 |url-status=live }}</ref> The prosecutor asserted Letby had injected air into the bloodstream of two victims and had used insulin to murder others. It was also revealed during the trial that Letby had to be told more than once not to enter a room where the parents of one of the victims were grieving.<ref>{{Cite news |date=31 October 2022 |title=Lucy Letby asked to leave baby's grieving family, trial hears |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63433599 |access-date=31 October 2022 |archive-date=31 October 2022 |archive-url=https://web.archive.org/web/20221031170925/https://www.bbc.com/news/uk-england-merseyside-63433599 |url-status=live }}</ref> Letby said, "It's always me when it happens."{{R|Panorama|at=15:35}}
Letby's defence lawyer said that Letby was "a dedicated nurse in a system which has failed," that the prosecution's case was "driven by the assumption that someone was doing deliberate harm combined with the coincidence on certain occasions of Miss Letby's presence," and that there had been a "massive failure of care in a busy hospital neonatal unit – far too great to blame on one person."<ref>{{Cite news|last=Lennox |first=Aaran |date=13 October 2022 |title=Lucy Letby a 'dedicated' nurse in 'system which has failed', court hears |url=https://www.dailypost.co.uk/news/north-wales-news/lucy-letby-dedicated-nurse-system-25257464 |access-date=27 October 2022 |work=North Wales Live |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027201018/https://www.dailypost.co.uk/news/north-wales-news/lucy-letby-dedicated-nurse-system-25257464 |url-status=live }}</ref> The defence argued that "extraordinary bleeding" in a baby boy murdered by Letby could have been caused by a rigid wire or tube.<ref>{{Cite news |title=Lucy Letby trial: Rigid wire or tube could have caused baby's 'extraordinary bleeding', court told |url=https://news.sky.com/story/lucy-letby-trial-rigid-wire-or-tube-could-have-caused-babys-extraordinary-bleeding-court-told-12750428 |access-date=19 November 2022 |work=Sky News |archive-date=19 November 2022 |archive-url=https://web.archive.org/web/20221119021335/https://news.sky.com/story/lucy-letby-trial-rigid-wire-or-tube-could-have-caused-babys-extraordinary-bleeding-court-told-12750428 |url-status=live }}</ref><ref>{{Cite news |date=24 November 2022 |title=Lucy Letby: 'Extremely high' dose of insulin found in baby allegedly poisoned |url=https://www.itv.com/news/granada/2022-11-24/lucy-letby-extremely-high-dose-of-insulin-found-in-baby-allegedly-poisoned |access-date=24 November 2022 |work=ITV News |archive-date=24 November 2022 |archive-url=https://web.archive.org/web/20221124161223/https://www.itv.com/news/granada/2022-11-24/lucy-letby-extremely-high-dose-of-insulin-found-in-baby-allegedly-poisoned |url-status=live }}</ref> The therapeutic use of insulin was denied by Letby's colleagues.<ref>{{Cite news |date=23 November 2022 |title=Lucy Letby colleagues tell murder trial they did not give baby insulin |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63735668 |access-date=24 November 2022 |archive-date=23 November 2022 |archive-url=https://web.archive.org/web/20221123223930/https://www.bbc.com/news/uk-england-merseyside-63735668 |url-status=live }}</ref>
A key piece of evidence was also given by a consultant who recounted that in February 2016 he had walked in and seen Letby standing over a baby and watching when they seemed to have stopped breathing.{{R|Panorama|at=22:45}} Letby was not doing anything despite the baby desaturating.{{R|Panorama|at=22:55}} When he asked her what was going on, she responded that he had only then just started declining.{{R|Panorama|at=23:05}} This baby went on to survive their collapse.{{R|Panorama|at=23:20}} By this stage all seven of the paediatrician consultants who worked on the neonatal ward agreed something was seriously wrong in the department.{{R|Panorama|at=23:25}} The deaths and near-deaths that were happening on the unit could not be medically explained.{{R|Panorama|at=24:30}} All the babies involved had been expected to live and so their deaths came out of the blue.{{R|ITV|at=11:17}} Previously, in the majority of times the premature babies had collapsed it had already been expected and in the very rare cases it was not already expected it could still be medically explained, unlike in all of these cases.{{R|ITV|at=11:30}} A paediatrician testified that he and other clinicians had previously raised concerns about Letby, but were told by hospital administration that they "should not really be saying such things" and "not to make a fuss." Another doctor testified that Letby commented an hour before one victim died, "He's not leaving here alive, is he?"<ref>{{Cite news |date=24 October 2022 |title=Lucy Letby trial: Nurse thought 'not again' over baby collapse |work=BBC News |url=https://www.bbc.com/news/uk-england-merseyside-63378514 |access-date=28 October 2022 |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027163619/https://www.bbc.com/news/uk-england-merseyside-63378514 |url-status=live}}</ref><ref>{{Cite news |title=Lucy Letby trial hears how doctor raised concerns but was told 'not to make a fuss' |url=https://news.sky.com/story/lucy-letby-trial-hears-how-doctor-raised-concerns-but-was-told-not-to-make-a-fuss-12729381 |access-date=28 October 2022 |work=Sky News |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028145706/https://news.sky.com/story/lucy-letby-trial-hears-how-doctor-raised-concerns-but-was-told-not-to-make-a-fuss-12729381 |url-status=live }}</ref><ref>{{Cite news |last1=Ball |first1=Tom |last2=Bunyan |first2=Bunyan |title=Lucy Letby trial: Doctor told 'not to make a fuss' over deaths of babies |work=[[The Times]] |url=https://www.thetimes.co.uk/article/lucy-letby-trial-doctor-told-not-to-make-a-fuss-over-deaths-of-babies-76x9t6wpr |access-date=28 October 2022 |issn=0140-0460 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028124625/https://www.thetimes.co.uk/article/lucy-letby-trial-doctor-told-not-to-make-a-fuss-over-deaths-of-babies-76x9t6wpr |url-status=live }}</ref>
Between March and June 2016 another three babies almost died while under Letby's care.{{R|Panorama|at=26:00}} Towards the end of June, she was helping to care for triplets.{{R|Panorama|at=26:05}} One died at 6 pm one evening and another of the triplets died less than 24 hours later, both under Letby's watch.{{R|Panorama|at=26:10}} Both of them had been in very good health and the deaths on consecutive days were causing staff considerable distress and shock, with the notable exception of Letby, who merely told one consultant that she would be back on shift the next day when she was asked if she was upset after the events of the two days.{{R|Panorama|at=26:25}} This was not the first time that twins/triplets had collapsed within 24 hours of each other while under Letby's care, as two twins had experienced collapses on consecutive days in August 2015.{{R|Panorama|at=37:00}} Only hours after one of the twins had died that month, the other became seriously unwell and it was only during the police investigation and after analysis of a blood sample that it was found that someone had intentionally poisoned the baby with insulin.{{R|Panorama|at=37:05}} This evidence had been missed for two years.{{R|Panorama|at=40:35}} The insulin, which had not been prescribed to the child, was identifiable as exogenous pharmaceutical insulin as C-peptide would be present in the specimen if the insulin had been produced by the baby.{{R|Panorama|at=39:45}}<ref name="Guardian timeline"/> Laboratory analysis also showed that Child L had been poisoned with insulin.<ref name="ITV">{{cite AV media
| people = [[ITV (TV Network)|ITV]]
| date = 19 August 2023
| title = Lucy Letby: The Nurse Who Killed
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| type = TV documentary
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| url = https://www.itv.com/watch/lucy-letby-the-nurse-who-killed/10a5003
| access-date = 23 August 2023
| archive-url =
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}}</ref>{{R|ITV|at=9:40}}<ref name="List of all charges i">{{cite news |last1=Finnis |first1=Alex |title=Lucy Letby trial verdict explained: The full list of charges, and how many murders she's been found guilty of |url=https://inews.co.uk/news/lucy-letby-trial-verdict-explained-full-list-charges-murders-guilty-2556833 |access-date=23 August 2023 |work=i |date=18 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084037/https://inews.co.uk/news/lucy-letby-trial-verdict-explained-full-list-charges-murders-guilty-2556833 |url-status=live }}</ref> This was also significant as only hours later his twin brother, Child M, inexplicably collapsed while under Letby's care but managed to survive after thirty minutes of resuscitation.{{R|ITV|at=9:40}} It was believed that Letby had injected air into the latter's bloodstream.<ref name="List of all charges i" /> The prosecution also noted that, although by this point she was not supposed to work night shifts, Letby was caring for Child L as she specifically volunteered to do an extra shift to care for it, the prosecution arguing that she had seen an opportunity here to kill Child L where she had failed previously with Child F.<ref name="Light"/> Letby herself accepted at trial that the results showed that some victims had been deliberately injected with insulin and did not contest that someone must have administered it to them.<ref name="Contest">{{cite news |title=Lucy Letby appeal fund launched |url=https://www.telegraph.co.uk/news/2023/08/23/lucy-letby-campaigners-freedom-launch-fundraising-appeal/ |access-date=24 August 2023 |work=The Telegraph |date=23 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824022301/https://www.telegraph.co.uk/news/2023/08/23/lucy-letby-campaigners-freedom-launch-fundraising-appeal/ |url-status=live }}</ref> The night after Letby tried to murder Child F she went salsa dancing.<ref name="Salsa">{{cite news |title=Lucy Letby trial: Nurse went dancing after alleged murder bid, jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63720819 |access-date=25 August 2023 |work=BBC News |date=22 November 2022 |archive-date=3 December 2022 |archive-url=https://web.archive.org/web/20221203023510/https://www.bbc.co.uk/news/uk-england-merseyside-63720819 |url-status=live }}</ref>
Although the consultants made their desire to have Letby removed from duties known to hospital staff after the triplet incident, this was refused and the next day another baby almost died under Letby's care.{{R|Panorama|at=26:20}} As well as in the two cases in which insulin poisoning had been proved, evidence provided by medical experts indicated that all the babies had been harmed intentionally.{{R|Panorama|at=42:05}} This evidence was given by experts specialising in areas of paediatric radiology, paediatric pathology, haematology, paediatric neurology and paediatric endocrinology, with two main medical experts who were consultant paediatricians.<ref name="CC">{{cite web |title=Nurse found guilty of the murder and attempted murder of premature babies |url=https://www.cheshire.police.uk/news/cheshire/news/articles/2023/8/nurse-found-guilty-of-the-murder-and-attempted-murder-of-premature-babies/ |website=Cheshire Constabulary |access-date=25 August 2023 |archive-date=23 August 2023 |archive-url=https://web.archive.org/web/20230823042648/https://www.cheshire.police.uk/news/cheshire/news/articles/2023/8/nurse-found-guilty-of-the-murder-and-attempted-murder-of-premature-babies/ |url-status=live }}</ref> Letby was the only staff member on duty for every one of the 25 suspicious incidents.{{R|Panorama|at=43:00}} After her removal from duty, and the downgrade of the unit,<ref name="Lintern" /><ref name="nursingtimes_20230818" /> to concentrate on lower risk babies, no further incidents were deemed suspicious.{{R|Panorama|at=29:15}}{{Better source needed|date=November 2023|reason=This source is based on, and includes interviews with those involved, and is contemporaneous with the event, so is [[WP:PRIMARY]] with a reporting slant. A suitable secondary source is required.}} Importantly, it was discovered that Letby had falsified patient records, covering her tracks by changing the times some babies collapsed to make sure she could not be placed at the scene.{{R|ITV|at=16:00}} [[Criminal psychologist]] Dr David Holmes states that the varied methods she used to attack her victims, such as insulin and air injections and overfeeding milk, would all have been specifically chosen as things that would dissipate and not be easily detected afterwards.{{R|Sky special|at=34:10}}
On the fourth day of trial, the prosecution presented a handwritten note from Letby which said "I am evil, I did this," and that she "killed them on purpose" because she "couldn't take care of them."<ref>{{Cite news |title=Lucy Letby trial – 'I am evil, I did this': Read the 'confession note' written by nurse accused of murdering seven babies |url=https://news.sky.com/story/lucy-letby-trial-i-am-evil-i-did-this-read-the-confession-note-written-by-nurse-accused-of-murdering-seven-babies-12718882 |access-date=27 October 2022 |work=Sky News |archive-date=27 October 2022 |archive-url=https://web.archive.org/web/20221027201008/https://news.sky.com/story/lucy-letby-trial-i-am-evil-i-did-this-read-the-confession-note-written-by-nurse-accused-of-murdering-seven-babies-12718882 |url-status=live }}</ref> It further stated "I killed them" and "I'll never marry or have children, I'll never know what it's like to have a family".{{R|Panorama|at=46:00}}<ref name="Never marry">{{cite news |title=Lucy Letby trial: Murder-accused nurse wrote 'I am evil', trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-63238989 |access-date=25 August 2023 |work=BBC News |date=13 October 2022 |archive-date=23 August 2023 |archive-url=https://web.archive.org/web/20230823174311/https://www.bbc.co.uk/news/uk-england-merseyside-63238989 |url-status=live }}</ref><ref name="'Geek'" /> The defence argued that the note was "the anguished outpouring of a young woman in fear and despair when she realises the enormity of what's being said about her, in the moment to herself" and said that Letby had written it when she was dealing with employment issues, including a grievance procedure with the NHS Trust. Several other notes from Letby were shown in court, two of which said, "Why/how has this happened – what process has led to this current situation? What allegations have been made and by who? Do they have written evidence to support their comments?" And, "I haven't done anything wrong and they have no evidence so why have I had to hide away?". The prosecution said that Letby was expressing through the notes her frustration about not being allowed back to work in the neonatal unit.<ref>{{Cite news |title=Revealed: The 'I am evil' handwritten note by Lucy Letby found at her Chester home |url=https://www.leaderlive.co.uk/news/23046837.revealed-i-evil-handwritten-note-lucy-letby-found-chester-home/ |first=Mark|last=Dowling|access-date=28 October 2022 |work=The Leader |date=13 October 2022 |archive-date=28 October 2022 |archive-url=https://web.archive.org/web/20221028195619/https://www.leaderlive.co.uk/news/23046837.revealed-i-evil-handwritten-note-lucy-letby-found-chester-home/ |url-status=live }}</ref> The police had also discovered that Letby had secretly kept medical documents at home relating to the care of the children.{{R|Panorama|at=44:00}} Jurors were told that 257 nursing handover sheets were found at addresses linked to Letby, of which 21 related to babies she had allegedly harmed.<ref>{{cite web|url=https://www.theguardian.com/uk-news/2023/apr/17/lucy-letby-initials-of-babies-on-dates-of-alleged-attacks-noted-in-diary-court-told|title=Lucy Letby: initials of babies noted in diary on dates of alleged attacks, court told|first=Josh|last=Halliday|work=The Guardian|date=17 April 2023|access-date=15 October 2023}}</ref> Her trial judge stated at sentencing that she had kept documents as "morbid records of the dreadful events surrounding the collapses of [her] victims and what [she] had done to them".<ref name="Sky evidence" /> The sensitive documents, which should never have left the hospital, contained the names of the babies and the documents had been stuffed and hidden away in shopping bags under her bed.<ref name="Sky evidence" />{{R|CC documentary|at=24:15}}{{R|Channel 4|at=7:00}} One note of medications given to a baby boy who had managed to survive after being on the brink of death, written on a paper towel, was found under Letby's bed.<ref name="Intensive2015" /> Letby claimed at trial that she had no means of destroying the confidential notes, yet the court heard a paper shredder which could have done so was found in her home.<ref name="Sky evidence" /> Her diary was also found to be marked with the initials of the babies she killed on the exact days they died.{{R|Channel 4|at=7:29}} It was within this diary that the note that stated "I am evil I did this" was tucked inside.{{R|Channel 4|at=7:36}} Furthermore, more notes were discovered that contained phrases such as "I'm sorry that you couldn't have a chance at life" , "I don't want to do this anymore", "how can life be this way?", "hate my life" and "help" in capital letters.<ref name="Sky evidence">{{cite news |last1=Williams |first1=Katie |title=The evidence seen during Lucy Letby's murder trial, from handwritten notes to cards for parents |url=https://news.sky.com/story/the-evidence-seen-during-lucy-letbys-murder-trial-from-handwritten-notes-to-cards-for-parents-12944606 |access-date=25 August 2023 |work=Sky News |date=22 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825093527/https://news.sky.com/story/the-evidence-seen-during-lucy-letbys-murder-trial-from-handwritten-notes-to-cards-for-parents-12944606 |url-status=live }}</ref><ref name="Love">{{cite news |title=Lucy Letby trial: Nurse's notes found in home search released |url=https://www.bbc.co.uk/news/uk-england-merseyside-65311400 |access-date=25 August 2023 |work=BBC News |date=18 April 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825214758/https://www.bbc.co.uk/news/uk-england-merseyside-65311400 |url-status=live }}</ref> The prosecution said the notes were evidently confessions of guilt, rather than just the words of a woman in "distress".<ref name="Sky evidence" /> These notes and documents had been found in searches of Letby's home in Chester and of her parents' house in Hereford.<ref name="Sky evidence" />
Letby herself gave evidence to the court in May 2023, breaking down in tears and claiming she was made to feel as though she were incompetent but "meant no harm."<ref>{{Cite magazine |title=Nurse Lucy Letby Sobs on Witness Stand, Claims She Was 'Incompetent' But Meant No Harm |url=https://people.com/crime/lucy-letby-nurse-sobs-witness-stand-claims-incompetent-meant-no-harm/ |access-date=3 May 2023 |magazine=People Magazine |archive-date=3 May 2023 |archive-url=https://web.archive.org/web/20230503024119/https://people.com/crime/lucy-letby-nurse-sobs-witness-stand-claims-incompetent-meant-no-harm/ |url-status=live }}</ref> When asked why she wrote the "I am evil, I did this," Letby said, "I felt at the time that if I'd done something wrong I must be such an evil, awful person. I'd somehow been incompetent and had done something wrong which had affected those babies."<ref name="auto">{{Cite news |last=Jolly |first=Bradley |date=2 May 2023 |title=Nurse Lucy Letby explains 'I am evil' note found after she 'murdered 7 babies' |url=https://www.mirror.co.uk/news/uk-news/nurse-lucy-letby-explains-i-29867123 |access-date=3 May 2023 |work=Mirror |archive-date=3 May 2023 |archive-url=https://web.archive.org/web/20230503024109/https://www.mirror.co.uk/news/uk-news/nurse-lucy-letby-explains-i-29867123 |url-status=live }}</ref> Letby said that the allegations had negatively impacted her mental health, saying, "I don't think you can be accused of anything worse than that. I just changed as a person, my mental health deteriorated, I felt isolated from my friends on the unit. From a self-confidence point of view, it made me question everything about myself." It was observed that Letby eventually began to lose her composure in the witness box, asking for a number of unplanned breaks.{{R|Panorama|at=51:00}} It was also observed that she only broke down when talking about herself and the impact it had on her, which the prosecution said was "telling".{{R|ITV|at=15:00}} She had not shown any emotion in relation to the fate of the babies.{{R|ITV|at=15:05}} It was also noted that she repeatedly contradicted herself, muddled up her story and became more and more frustrated with the prosecution's questions, which was unlike her usual calm demeanour.<ref>{{cite news |title=Who is Lucy Letby? The 'average' nurse who became one of Britain's most notorious child killers |url=https://news.sky.com/story/who-is-lucy-letby-the-average-nurse-who-became-britains-most-prolific-child-killer-12943602 |access-date=26 August 2023 |work=Sky News |date=21 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825092123/https://news.sky.com/story/who-is-lucy-letby-the-average-nurse-who-became-britains-most-prolific-child-killer-12943602 |url-status=live }}</ref>
====Verdicts and sentencing====
Final verdicts were returned by the jury on 18 August 2023.<ref>{{cite news |last=Halliday |first=Josh |date=18 August 2023 |title=Calls to force court appearances as Lucy Letby refuses to attend sentencing |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/18/calls-to-force-court-appearances-as-lucy-letby-refuses-to-attend-sentencing |access-date=18 August 2023 |archive-date=18 August 2023 |archive-url=https://web.archive.org/web/20230818153637/https://www.theguardian.com/uk-news/2023/aug/18/calls-to-force-court-appearances-as-lucy-letby-refuses-to-attend-sentencing |url-status=live }}</ref> Letby was found guilty of seven counts of murder of seven babies. She killed them by injecting them with air, overfeeding them, poisoning them with [[insulin]] and assaulting them with medical tools. She is the most prolific serial killer of children in modern British history.<ref name=BBCverdict>{{cite news|last1=O'Donoghue|last2=Moritz|last3=Hirst|last4= Lazaro|first1= Dan|first2= Judith|first3=Lauren|first4=Rachael|title= Nurse Lucy Letby guilty of murdering seven babies on neonatal unit|date=18 August 2023|url=https://www.bbc.co.uk/news/uk-england-merseyside-65960514 |access-date=18 August 2023 |work=BBC News |url-status=live |archive-url=https://web.archive.org/web/20230818190742/https://www.bbc.co.uk/news/uk-england-merseyside-65960514 |archive-date=18 August 2023}}</ref><ref>{{cite news |last=Sawyer|first=Patrick|title= Lucy Letby joins Myra Hindley on list of UK's worst child serial killers|url= https://www.telegraph.co.uk/news/2023/08/18/lucy-letby-ian-brady-uk-worst-serial-child-killers/|work= The Telegraph|date= 18 August 2023|access-date=19 August 2023 |url-status=live |archive-url=https://web.archive.org/web/20230819124715/https://www.telegraph.co.uk/news/2023/08/18/lucy-letby-ian-brady-uk-worst-serial-child-killers/ |archive-date=19 August 2023}}</ref>
Letby was also found guilty of seven counts of attempted murder of six infants. Letby was found not guilty on two counts of attempted murder.<ref name=BBCverdict/> The jury was unable to reach verdicts on six further attempted murder charges.<ref name=BBCverdict/> Nicholas Johnson <small>[[King's Counsel|KC]]</small> asked the court for 28 days to consider whether a retrial would be sought for these six counts.<ref>{{Cite news|url=https://www.bbc.com/news/uk-england-merseyside-65960514|title=Nurse Lucy Letby guilty of murdering seven babies on neonatal unit|work=BBC News|date=18 August 2023|accessdate=21 August 2023|archive-date=24 August 2023|archive-url=https://web.archive.org/web/20230824084038/https://www.bbc.com/news/uk-england-merseyside-65960514|url-status=live}}</ref>
On 21 August 2023, Letby was sentenced to [[life imprisonment in England and Wales|life imprisonment]] with a [[whole life order]], the most severe sentence possible under English law; she is the fourth woman in UK legal history to receive such a sentence.<ref>{{cite web|url=https://www.nationalworld.com/news/crime/whole-life-order-killers-female-uk-criminal-parole-lucy-letby-awaits-sentence-4261606 |title=Every female British murderer given a whole life order |work=National World |date=21 August 2023 |accessdate=21 August 2023}}</ref> Goss said that Letby committed "a cruel, calculated and cynical campaign of child murder involving the smallest and most vulnerable of children." In closing, he stated, "there was a deep malevolence bordering on sadism [...] you [Letby] have no remorse [...] there are no mitigating factors [...] the offences are of sufficient severity to require a whole life order."<ref name="BBC 66551231">{{cite news |title=Lucy Letby sentencing live: Nurse to spend rest of life in prison |url=https://www.bbc.co.uk/news/live/uk-66551231 |access-date=21 August 2023 |work=BBC News |date=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821120846/https://www.bbc.co.uk/news/live/uk-66551231 |url-status=live }}</ref><ref>{{cite web |title=Letby Sentencing Remarks |url=https://www.judiciary.uk/wp-content/uploads/2023/08/LETBY-Sentencing-Remarks.pdf |website=judiciary.gov.uk |publisher=Manchester Crown Court |access-date=23 August 2023 |date=21 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084037/https://www.judiciary.uk/wp-content/uploads/2023/08/LETBY-Sentencing-Remarks.pdf |url-status=live }}</ref>
Letby opted{{R|ITV|at=18:50}} not to attend the [[sentencing]] hearing and as such heard neither the various [[victim impact statement]]s which were read out, nor her sentence being passed.<ref name="BBC 66569311">{{cite news |date=21 August 2023 |title=Serial killer nurse Lucy Letby given whole-life sentence |work=BBC News |url=https://www.bbc.co.uk/news/uk-england-merseyside-66569311 |access-date=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821154940/https://www.bbc.co.uk/news/uk-england-merseyside-66569311 |url-status=live }}</ref><ref>{{cite news |last=Halliday |first=Josh |date=21 August 2023 |title=Lucy Letby sentenced to whole-life jail term for murdering seven babies |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-sentence-whole-life-jail-term-for-murdering-seven-babies |access-date=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821144644/https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-sentence-whole-life-jail-term-for-murdering-seven-babies |url-status=live }}</ref> In response, [[Alex Chalk]], [[Secretary of State for Justice (UK)|Secretary of State for Justice]], wrote that the government will "look at options to change the law at the earliest opportunity" to compel defendants to attend their sentencing.<ref>{{Cite news |last=Siddique |first=Haroon |last2= |first2= |last3= |first3= |date=21 August 2023 |title=Lucy Letby becomes fourth woman in UK to receive whole-life jail term after murdering seven babies – latest updates |work=The Guardian |url=https://www.theguardian.com/uk-news/live/2023/aug/21/lucy-letby-sentencing-hearing-life-sentence-updates |access-date=21 August 2023 |issn=0261-3077 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821190553/https://www.theguardian.com/uk-news/live/2023/aug/21/lucy-letby-sentencing-hearing-life-sentence-updates |url-status=live }}</ref> On 30 August 2023, Prime Minister [[Rishi Sunak]] announced that the [[Government of the United Kingdom|UK government]] would introduce legislation to Parliament that would compel convicted criminals to attend their sentencing hearings, by force if necessary, or face the prospect of more time in prison.<ref>{{cite web |first1=Tom |last1=Symonds |first2=Aoife |last2=Walsh |url=https://www.bbc.com/news/uk-66660136 |title=Criminals to be forced to attend sentencing hearings |work=BBC News |date=31 August 2023 |access-date=11 March 2024 |archive-url=https://web.archive.org/web/20230904190234/https://www.bbc.com/news/uk-66660136 |archive-date=4 September 2023 |url-status=live }}</ref>
After the trial, Lucy Letby was transferred to [[HMP Low Newton]], a [[Prison security categories in the United Kingdom|closed]] prison for women in [[County Durham]].<ref name="theguardian1">{{cite news |title=Inside Low Newton: the high security prison that will house Lucy Letby' |url=https://www.theguardian.com/uk-news/2023/aug/21/inside-low-newton-the-high-security-prison-that-is-housing-lucy-letby |access-date=21 August 2023 |newspaper=Guardian |date=21 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824083539/https://www.theguardian.com/uk-news/2023/aug/21/inside-low-newton-the-high-security-prison-that-is-housing-lucy-letby |url-status=live }}</ref> {{asof|January 2024}}, Letby is being held in [[HM Prison Bronzefield]].<ref>{{Cite web |date=2024-01-29 |title=Serial killer nurse Lucy Letby has 'keys to her own cell' and leads cushy life |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-serial-killer-nurse-prison-b2486468.html |access-date=2024-02-11 |website=The Independent |language=en}}</ref>
====Appeal====
In January 2024, Letby applied to the [[Court of Appeal (England and Wales)|Court of Appeal]] for permission to appeal her convictions which a judge refused. Letby renewed her application in February 2024. Following a three-day hearing in April 2024, three judges of the Court of Appeal reserved judgement, their written decision whether to grant permission to be issued at some later date.<ref name="Pidd 2024">{{cite news |first1=Helen |last1=Pidd |title=Child serial killer Lucy Letby loses initial attempt to challenge convictions |url=https://www.theguardian.com/uk-news/2024/jan/30/child-serial-killer-lucy-letby-loses-initial-attempt-challenge-convictions |website=The Guardian |date=30 January 2024 |access-date=30 January 2024 }}</ref><ref>{{Cite news |date=2024-02-07 |title=Lucy Letby renews bid to appeal her convictions |url=https://www.bbc.com/news/uk-england-manchester-68233226 |access-date=2024-02-18 |work=BBC News |language=en-GB}}</ref><ref name=":5">{{Cite web |title=Court of Appeal cases fixed for hearing (Criminal Division) |url=https://www.gov.uk/government/publications/court-of-appeal-cases-fixed-for-hearing-criminal-division/court-of-appeal-cases-fixed-for-hearing-criminal-division |access-date=2024-04-11 |website=GOV.UK |language=en}}</ref><ref>{{Cite web |date=2024-04-25 |title=Lucy Letby: Judges reserve judgement on appeal bid |url=https://www.bbc.com/news/articles/ce965klgv01o |access-date=2024-04-26 |website=BBC News |language=en-GB}}</ref>
====Scheduled retrial====
At a hearing on 25 September 2023, the CPS confirmed that there would be a retrial on one of the six counts of attempted murder against Letby on which the jury at the original trial could not reach a verdict. A date of 10 June 2024 has been set but the trial will not be conducted until after judges had decided whether or not to grant Letby permission to appeal against her existing convictions.<ref>{{cite news |last1=Halliday |first1=Josh |title=Lucy Letby to face retrial on charge of trying to murder baby girl, court told |url=https://www.theguardian.com/uk-news/2023/sep/25/lucy-letby-retrial |access-date=25 September 2023 |work=The Guardian |date=25 September 2023}}</ref>
===Disciplinary action===
Letby was removed from the nursing register on 12 December 2023, having informed the Nursing and Midwifery Council that she did not accept guilt but did not contest the removal.<ref>{{cite news |title=Convicted child serial killer Lucy Letby struck off nursing register |url=https://www.theguardian.com/uk-news/2023/dec/12/convicted-child-serial-killer-lucy-letby-struck-off-nursing-register |website=Guardian |date=12 December 2023 |access-date=12 December 2023 |last1=Media |first1=P. A. }}</ref>
===Motives===
During Letby's trial, the prosecution suggested several possible motives for the killings including boredom, that she "got a thrill" from the events surrounding the deaths and that she enjoyed "[[Playing God (ethics)|playing God]]". The prosecution told the jury that "[s]he was controlling things. She was enjoying what was going on. She was predicting things that she knew was going to happen." Another possible motivation suggested by the prosecution was that the killings were to gain the attention of a married doctor with whom Letby allegedly had a secret relationship. She had texted this doctor 'non-stop' during some night shifts, minutes before attacking babies.{{R|Panorama|at=14:30}} One sheet of paper found in Letby's office and shown to the court was an annual leave form, on which Letby had written phrases including, "I trusted you with everything and loved you", "you were my best friend" and "please help me".<ref name="Lovedyou">{{cite news |title=Lucy Letby trial: Nurse's notes read 'I killed them', jury told |url=https://www.bbc.co.uk/news/uk-england-merseyside-65299827 |access-date=25 August 2023 |work=BBC News |date=17 April 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215119/https://www.bbc.co.uk/news/uk-england-merseyside-65299827 |url-status=live }}</ref> The doctor was one of those called when a baby rapidly deteriorated. Letby denied all these suggestions, including the allegation that she had a relationship with the married doctor<ref name=Guardianmotives>{{cite news |last1=Halliday |first1=Josh |title=What were Lucy Letby's possible motives for murdering babies? |url=https://www.theguardian.com/uk-news/2023/aug/18/what-were-lucy-letbys-possible-motives-for-murdering-babies |work=The Guardian |date=18 August 2023 |access-date=19 August 2023|url-status=live |archive-url=https://web.archive.org/web/20230818234607/https://www.theguardian.com/uk-news/2023/aug/18/what-were-lucy-letbys-possible-motives-for-murdering-babies |archive-date=18 August 2023}}</ref> She denied that she had a crush on him and when asked why she tried to leave the dock without permission when he was giving evidence, Letby said she had "felt unwell".{{R|ITV|at=14:30}}<ref>{{cite news |title=Lucy Letby denies rooting in bin after baby resuscitation |url=https://www.bbc.co.uk/news/uk-england-merseyside-65834779 |access-date=25 August 2023 |work=BBC News |date=7 June 2023 |archive-date=26 August 2023 |archive-url=https://web.archive.org/web/20230826005841/https://www.bbc.co.uk/news/uk-england-merseyside-65834779 |url-status=live }}</ref>
''[[The Guardian]]'', in its reporting after the verdict, said that "[t]he closest the prosecution had to a confession" were [[Post-it Note|post-it notes]] found in Letby's handbag after her arrest. The notes bore hand-written jottings, one of which read, "I killed them on purpose because I'm not good enough to care for them." During the trial Letby denied this was a confession and that it was merely a reflection of her mental turmoil written while she was being investigated.<ref name=Guardianmotives/>'' [[The Telegraph (UK)|The Telegraph]]'' also noted though that she had also suggested another motivation was her fear of never finding love or having children of her own, writing on the note: "I'll never marry or have children, I'll never know what it's like to have a family."<ref name="'Geek'">{{cite news |title=Lucy Letby: Quiet 'geek' who became a killer feared she would never have children of her own |url=https://www.telegraph.co.uk/news/2023/08/18/how-lucy-letby-became-britains-most-prolific-baby-killer/ |access-date=26 August 2023 |work=The Telegraph |date=18 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825203936/https://www.telegraph.co.uk/news/2023/08/18/how-lucy-letby-became-britains-most-prolific-baby-killer/ |url-status=live }}</ref><ref name="Never marry" />
A former detective superintendent, the lead detective on the [[Beverley Allitt]] case of the 1990s, said that the amount of parallels between the cases made him think that "it's almost as if somebody's read the Allitt book" and that Letby's crimes may have been copycats.{{R|ITV|at=17:30}} Allitt had attacked over a dozen infants in her care while working as a nurse in [[Grantham]], England, and the methods used in the cases were apparently identical, with Allitt having also injected some victims with air and insulin and physically assaulting them.{{R|ITV|at=17:30}} It was believed that Allitt may have been motivated by what was then called [[Münchausen syndrome by proxy]], now known as factitious disorder imposed on another (FDIA), in which she harmed others to gain attention for herself. The theory that this could explain Letby's attacks was supported by [[criminal psychologist]] Dominic Wilmott.{{R|ITV|at=18:00}} Fellow criminal psychologist Dr David Holmes agreed that Letby was motivated by FDIA.<ref name="Sky special">{{cite AV media
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}}</ref><sup><!--|at=-->31:15</sup> Just like in Letby's case, the hospital in Allitt's case was criticised for its slow speed of response.<ref name="Newsnight">{{cite web |title=Lucy Letby: A timeline of the most prolific child killer in modern Britain - BBC Newsnight |url=https://www.youtube.com/watch?v=oVLx9U6MFXU |publisher=BBC News |access-date=25 August 2023 |date=22 August 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825161610/https://www.youtube.com/watch?v=oVLx9U6MFXU |url-status=live }}</ref>
In an opinion piece published in the [[The Guardian|Guardian]] in August 2023, [[David Wilson (criminologist)|David Wilson]], an emeritus professor of [[criminology]], considered it possible that Letby was driven by a "[[hero complex]]".<ref>{{cite web|url=https://www.theguardian.com/uk-news/commentisfree/2023/aug/20/lucy-letby-confirms-yet-confounds-our-ideas-of-a-serial-killer|title=Lucy Letby confirms yet confounds our ideas of a serial killer|first=David|last=Wilson|work=[[The Guardian]]|date=20 August 2023|access-date=15 March 2024}}</ref> A senior nurse testified on 21 March 2023 that Letby had told her before June 2016 that she, Letby, found non-intensive care of babies "boring" and had always wanted to be allocated to the intensive care unit, notwithstanding concerns among nursing staff that working long periods in intensive care would place a high burden on the mental health of nurses.<ref name="boring">{{cite news |title=Lucy Letby found caring for less sick babies 'boring', trial told |url=https://www.bbc.co.uk/news/uk-england-merseyside-65029970 |access-date=25 August 2023 |work=BBC News |date=21 March 2023 |archive-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825215129/https://www.bbc.co.uk/news/uk-england-merseyside-65029970 |url-status=live }}</ref> According to Wilson, healthcare killers like Letby "[have] already developed the desire to kill before they join the healthcare setting".<ref name="Newsnight" /> Speaking on ''[[Newsnight]]'', he said: "If you want to kill, of course you are going to identify people who are vulnerable. People whose deaths won't be noticed. And so guess what? The people that serial killers target, by and large, are older people, or they target very very young people, specifically in a neonatal unit in this case, where again small babies with chronic underlying healthcare where their deaths won't be commented upon or seen as being suspicious".<ref name="Newsnight" />
===Post-conviction===
====Further investigations====
Following the verdict, it was reported that police were investigating whether Letby harmed other babies. There was a continuing investigation of incidents which detectives had identified as "suspicious" at the Countess of Chester Hospital involving around 30 other infants. Neonatologists looked into about 4,000 admissions at the hospital and [[Liverpool Women's Hospital]], where Letby had worked from 2012 to 2015, and were to pass on any cases of "unexpected and unexplained" deteriorations to police. At least one family was told by police that the birth of their child at the latter hospital was part of the enquiry.<ref name="guardian_20230820">{{Cite news |last1=Halliday |first1=Josh |date=20 August 2023 |title=Lucy Letby may have harmed dozens more babies, police fear |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/20/lucy-letby-dozens-more-babies-police-believe-chester-liverpool |access-date=20 August 2023 |issn=0261-3077 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821021318/https://www.theguardian.com/uk-news/2023/aug/20/lucy-letby-dozens-more-babies-police-believe-chester-liverpool |url-status=live }}</ref><ref>{{cite news|last= Vaughan|first= Henry|url= https://news.sky.com/story/lucy-letby-more-families-told-their-children-may-be-victims-of-killer-nurse-12931797|title= Lucy Letby: More families told their children may be victims of killer nurse - as police review care of 4,000 babies|date= 18 August 2023|work= Sky News|accessdate= 20 August 2023|archive-date= 19 August 2023|archive-url= https://web.archive.org/web/20230819233901/https://news.sky.com/story/lucy-letby-more-families-told-their-children-may-be-victims-of-killer-nurse-12931797|url-status= live}}</ref> Cheshire Police have said that further charges could "possibly" be brought against Letby as a result of these further investigations.{{R|Panorama|at=55:20}}
On 4 October 2023, Cheshire Constabulary announced an investigation into [[Corporate manslaughter in English law|corporate manslaughter]] at the Countess of Chester Hospital.<ref>{{cite web |title=Cheshire Constabulary statement regarding Countess of Chester Hospital (4 October 2023) |url=https://www.cheshire.police.uk/news/cheshire/news/articles/2023/10/cheshire-constabulary-statement-regarding-countess-of-chester-hospital-4-october-2023/ |website=Cheshire Police |access-date=4 October 2023}}</ref>
====Thirlwall inquiry====
After Letby's conviction the UK government ordered an independent inquiry into the circumstances surrounding the murders.<ref>{{cite web|url=https://www.gov.uk/government/news/government-orders-independent-inquiry-following-lucy-letby-verdict|title=Government orders independent inquiry following Lucy Letby verdict|website=gov.uk|date=18 August 2023 |access-date=18 August 2023|archive-date=18 August 2023|archive-url=https://web.archive.org/web/20230818154140/https://www.gov.uk/government/news/government-orders-independent-inquiry-following-lucy-letby-verdict|url-status=live}}</ref> The [[Department of Health and Social Care]] said the inquiry would examine "the circumstances surrounding the deaths and incidents, including how concerns raised by clinicians were dealt with."<ref>{{cite news |url=https://www.itv.com/news/granada/2023-08-18/government-orders-independent-inquiry-into-nurse-who-murdered-babies-at-hospital |title=Lucy Letby: Government orders inquiry into nurse who murdered babies at hospital |work=ITV News |date=18 August 2023 |access-date=18 August 2023}}</ref> It was affirmed that the inquiry would be non-statutory, so witnesses could not be compelled to give evidence and inquests would still be necessary. The trust's medical director, chief executive and the nursing director at the time of the murders all commented they would fully cooperate with the inquiry.<ref>{{cite news|url=https://www.bbc.co.uk/news/uk-66547863|work=BBC News|title=Lucy Letby: Government orders independent inquiry|date=18 August 2023|access-date=19 August 2023|archive-date=20 August 2023|archive-url=https://web.archive.org/web/20230820211315/https://www.bbc.co.uk/news/uk-66547863|url-status=live}}</ref><ref name=Lintern/> The medical director retired in August 2018 and the chief executive resigned in September 2018 after signing a non-disclosure agreement.<ref name=Lintern/>
[[Slater and Gordon]], a law firm representing two of the victims' families, issued a statement calling for the inquiry to have the power to compel witnesses to participate, since a non-statutory hearing "must rely on the goodwill of those involved to share their testimony."<ref name=BBC66553245/> The need for a statutory inquiry was a view echoed by, among others, [[Sir Robert Buckland]], former [[Secretary of State for Justice]],<ref>{{cite news |url=https://news.sky.com/story/lucy-letbys-refusal-to-appear-in-court-sparks-renewed-calls-for-change-to-law-12943015 |title=Lucy Letby's refusal to appear in court sparks renewed calls for change to law |work=Sky News |date=20 August 2023 |accessdate=20 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820142752/https://news.sky.com/story/lucy-letbys-refusal-to-appear-in-court-sparks-renewed-calls-for-change-to-law-12943015 |url-status=live }}</ref> [[Samantha Dixon]], MP for the [[City of Chester (UK Parliament constituency)|City of Chester]],<ref name=BBC66553245>{{cite news |url=https://www.bbc.co.uk/news/uk-66553245 |title=Lucy Letby: Families of victims call for greater powers in inquiry |work=BBC News |date=19 August 2023 |access-date=19 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820073714/https://www.bbc.co.uk/news/uk-66553245 |url-status=live }}</ref> [[Steve Brine]], chair of the [[Health and Social Care Select Committee|House of Commons Health and Social Care Select Committee]],<ref>{{cite news |first=James |last=Gregory |url=https://www.bbc.co.uk/news/uk-66562938 |title=Lucy Letby inquiry should be led by judge, committee chair says |work=BBC News |date=20 August 2023 |accessdate=20 August 2023 |archive-date=20 August 2023 |archive-url=https://web.archive.org/web/20230820175500/https://www.bbc.co.uk/news/uk-66562938 |url-status=live }}</ref> [[Sir Keir Starmer]], [[Leader of the Opposition (United Kingdom)|Leader of the Opposition]],<ref>{{cite news |url=https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-murders-victims-families-and-experts-call-for-statutory-inquiry |title=Lucy Letby inquiry could be upgraded to compel witnesses, No 10 indicates |work=[[The Guardian]] |date=21 August 2023 |first1=Pippa |last1=Crerar |author-link1=Pippa Crerar |first2=Josh |last2=Halliday |first3=Haroon |last3=Siddique |access-date=22 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821221641/https://www.theguardian.com/uk-news/2023/aug/21/lucy-letby-murders-victims-families-and-experts-call-for-statutory-inquiry |url-status=live }}</ref> and the Parliamentary and Health Service Ombudsman.<ref name="Ombudsman">{{cite web |title=Ombudsman writes to Health Secretary calling for statutory inquiry and action on patient safety in wake of Letby trial |url=https://www.ombudsman.org.uk/news-and-blog/news/ombudsman-writes-health-secretary-calling-statutory-inquiry-and-action-patient |website=Parliamentary and Health Service Ombudsman |access-date=29 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824155103/https://www.ombudsman.org.uk/news-and-blog/news/ombudsman-writes-health-secretary-calling-statutory-inquiry-and-action-patient |url-status=live }}</ref>
The education minister [[Gillian Keegan]] said that the type of inquiry would be reviewed after the chair was appointed.<ref>{{cite news |title=Lucy Letby: doctor who raised alarm calls for regulation of NHS executives |url=https://www.theguardian.com/society/2023/aug/22/lucy-letby-doctor-stephen-brearey-regulation-nhs-executives-call |first=Geneva|last=Abdul|work=The Guardian |access-date=22 August 2023 |archive-date=22 August 2023 |archive-url=https://web.archive.org/web/20230822093812/https://www.theguardian.com/society/2023/aug/22/lucy-letby-doctor-stephen-brearey-regulation-nhs-executives-call |url-status=live }}</ref><ref>{{cite news|url=https://www.theguardian.com/uk-news/2023/aug/25/ministers-indicate-support-for-statutory-inquiry-into-lucy-letby-killings|title=Ministers indicate support for statutory inquiry into Lucy Letby killing|work=The Guardian|date=25 August 2023 |access-date=26 August 2023|archive-date=26 August 2023|archive-url=https://web.archive.org/web/20230826050358/https://www.theguardian.com/uk-news/2023/aug/25/ministers-indicate-support-for-statutory-inquiry-into-lucy-letby-killings|url-status=live |last1=Rawlinson |first1=Kevin |last2=Mason |first2=Rowena }}</ref> On 30 August 2023, Health Secretary [[Steve Barclay]] announced that the inquiry had been upgraded to a [[statutory inquiry]], describing it as the best way forward and meaning that witnesses would be compelled to give evidence.<ref>{{cite web |url=https://www.bbc.co.uk/news/health-66597122 |title=Lucy Letby: Inquiry given powers to compel witnesses to give evidence |work=BBC News |date=30 August 2023 |access-date=30 August 2023 |archive-date=30 August 2023 |archive-url=https://web.archive.org/web/20230830175127/https://www.bbc.co.uk/news/health-66597122 |url-status=live }}</ref>
[[Kathryn Thirlwall|Lady Justice Thirlwall]] was appointed to chair the inquiry.<ref>{{cite news |title=Lady Justice Thirlwall appointed to lead public inquiry into Lucy Letby |url=https://www.theguardian.com/uk-news/2023/sep/04/lucy-letby-lady-justice-thirlwall-to-lead-public-inquiry |website=Guardian |date=4 September 2023 |access-date=4 September 2023 |last1=Siddique |first1=Haroon }}</ref> The terms of reference of the inquiry were published on 19 October 2023 and updated on 22 November 2023,<ref>{{cite web |title=Thirlwall Inquiry: terms of reference |url=https://www.gov.uk/government/publications/thirlwall-inquiry-terms-of-reference/thirlwall-inquiry-terms-of-reference |website=GOV.UK |access-date=22 November 2023}}</ref> when she formally opened the inquiry.<ref>{{Cite web |first1=Daniel |last1=O'Donoghue |first2=Judith |last2=Moritz |url=https://www.bbc.com/news/uk-england-merseyside-67488797 |title=Lucy Letby public inquiry formally opened by judge |date=22 November 2023 |accessdate=22 November 2023 |work=BBC News |publisher=BBC}}</ref>
====Calls for regulation and reform====
The [[British Medical Association]], which represents doctors, called for a process for NHS managers and healthcare administrators to be held accountable for mismanagement, in a similar way to how the [[General Medical Council]] may [[Struck off|strike off]] doctors who harm patients.<ref>{{cite news |last1=Malnick |first1=Edward |last2=Sawer |first2=Patrick |last3=Bird |first3=Steve |title=Doctors wage war on NHS managers after Letby murders |url=https://www.telegraph.co.uk/news/2023/08/19/doctors-wage-war-on-nhs-managers-after-lucy-letby-murders/ |access-date=20 August 2023 |work=[[The Daily Telegraph|The Telegraph]] |date=19 August 2023 |archive-url=https://archive.today/20230819205849/https://www.telegraph.co.uk/news/2023/08/19/doctors-wage-war-on-nhs-managers-after-lucy-letby-murders/ |archive-date=19 August 2023}}</ref> A neonatal consultant who alerted administrators about his suspicions about Letby also called for regulation of healthcare management.<ref>{{Cite news |date=22 August 2023 |title=Lucy Letby: NHS managers must be held to account, doctor says |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-66578698 |access-date=24 August 2023|archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824013557/https://www.bbc.com/news/uk-66578698 |url-status=live }}</ref>
The [[Parliamentary and Health Service Ombudsman]] Rob Behrens, called for radical change to NHS management in order to prevent future similar occurrences.<ref name="Ombudsman" /><ref>{{Cite news |last=Gregory |first=Andrew |last2= |first2= |date=2023-08-27 |title=Lucy Letby case: more babies face harm unless NHS ends 'defensive leadership' |language=en-GB |work=The Guardian |url=https://www.theguardian.com/society/2023/aug/27/lucy-letby-case-more-babies-face-harm-defensive-leadership-nhs-ombudsman |access-date=2023-08-29 |issn=0261-3077 |archive-date=27 August 2023 |archive-url=https://web.archive.org/web/20230827160605/https://www.theguardian.com/society/2023/aug/27/lucy-letby-case-more-babies-face-harm-defensive-leadership-nhs-ombudsman |url-status=live }}</ref>
====Doubts about conviction====
A small number of Letby's friends and former colleagues continued to believe in her innocence.<ref name="Evans 2023">{{Cite news |last=Evans |first=Holly |date=27 August 2023 |title=Friends and colleagues of murderer Lucy Letby insist baby killing nurse is innocent |work=Independent |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |access-date=28 August 2023 |archive-date=28 August 2023 |archive-url=https://web.archive.org/web/20230828215353/https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |url-status=live }}</ref>
[[Rachel Aviv]], a staff writer at [[The New Yorker|''The New Yorker'']], published a feature article in May 2024 that questioned Letby's conviction.<ref name="TNY">{{Cite news |last=Aviv |first=Rachel |title=A British Nurse Was Found Guilty of Killing Seven Babies. Did She Do It? |work=The New Yorker |date=13 May 2024 |url=https://www.newyorker.com/magazine/2024/05/20/lucy-letby-was-found-guilty-of-killing-seven-babies-did-she-do-it}}</ref> In the article, Aviv highlighted how pervasive staffing shortages at Countess of Chester Hospital's neonatal unit had led to a dramatic increase in poor care outcomes both during and after Letby's tenure, and noted the consistent use of flawed statistical reasoning by prosecutors. In a case of the [[Texas sharpshooter fallacy]], Aviv claimed that prosecutors placed undue weight on events that supported their theory of the case, while discounting contradictory ones. Aviv also questioned the testimony of Dewi Evans, a retired [[consultant paediatrician]] and prosecution witness whose attestations had "laid the medical foundation for the prosecution’s case" despite a report prepared by Evans as an expert witness in a previous case having been deemed "worthless" as well as expressing opinions that were "tendentious and partisan" and "outside Dr. Evans' professional competence" by a Court of Appeals judge.<ref name="TNY" />
Statistician [[Richard D. Gill]] and lawyer Neil Mackenzie KC, who co-authored a work with others on the use of statistics in court cases, have also questioned the outcome.{{r|Steafal 2023}}<ref>{{Cite news |last=Davis |first=Nicola |date=3 October 2023 |title=Experts call for Lucy Letby inquiry to cover statistical evidence used in trial |language=en-GB |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/oct/03/lucy-letby-inquiry-statistical-evidence-used-in-trial |access-date=2023-10-06 |issn=0261-3077}}</ref> Gill has claimed that the trial was based on misleading or misapplied data which heavily implicated Letby, when in fact there are often clusters of deaths in hopsitals.<ref>{{cite web |last=Gill |first=Richard |title=The Timeline of the Conspiracy |date=12 October 2023 |url=https://gill1109.com/2023/10/12/the-timeline-of-the-conspiracy/}}</ref>
====Other reactions====
Dewi Evans has called for an investigation into the possibility of charges of [[corporate manslaughter]] in relation to the Letby case.<ref>{{Cite news |last=Halliday |first=Josh |date=19 August 2023 |title=Lucy Letby: Police urged to investigate hospital bosses for corporate manslaughter |work=The Guardian |url=https://www.theguardian.com/uk-news/2023/aug/19/lucy-letby-police-urged-to-investigate-hospital-bosses-for-corporate-manslaughter |access-date=20 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821022650/https://www.theguardian.com/uk-news/2023/aug/19/lucy-letby-police-urged-to-investigate-hospital-bosses-for-corporate-manslaughter |url-status=live }}</ref>
[[The Royal College of Paediatrics and Child Health]] stated, "We must learn from these crimes and how Lucy Letby was able to bring harm to these babies so that no situation like this can ever happen again" and welcomed the independent inquiry.<ref name=":2">{{cite web |title=RCPCH responds to verdict in Lucy Letby trial |url=https://www.rcpch.ac.uk/news-events/news/rcpch-responds-verdict-lucy-letby-trial |access-date=19 August 2023 |website=RCPCH |archive-date=19 August 2023 |archive-url=https://web.archive.org/web/20230819133710/https://www.rcpch.ac.uk/news-events/news/rcpch-responds-verdict-lucy-letby-trial |url-status=live }}</ref> [[NHS England]]'s Chief Nursing Officer [[Ruth May (nurse)|Dame Ruth May]] issued a statement saying, "The NHS is fully committed to doing everything we can to prevent anything like this ever happening again, and we welcome the independent inquiry announced by the Department of Health and Social Care to help ensure we learn every possible lesson from this awful case."<ref>{{cite web |title=NHS England » Commenting on the verdict in the Lucy Letby trial |url=https://www.england.nhs.uk/2023/08/commenting-on-the-verdict-in-the-lucy-letby-trial/ |access-date=19 August 2023 |website=www.england.nhs.uk |archive-date=19 August 2023 |archive-url=https://web.archive.org/web/20230819133717/https://www.england.nhs.uk/2023/08/commenting-on-the-verdict-in-the-lucy-letby-trial/ |url-status=live }}</ref>
On 21 August 2023, it was announced that the nursing director at the Countess of Chester Hospital at the time Letby was based there had been suspended from her job as a senior nursing officer at [[Northern Care Alliance NHS Foundation Trust]] with immediate effect, because of information that came to light during the trial.<ref name="BBC 66569258"/> The [[Nursing and Midwifery Council]] subsequently announced she would face an investigation into her fitness to practice.<ref>{{cite web |url=https://www.bbc.co.uk/news/uk-england-merseyside-66586463 |title=Lucy Letby: Claims nursing director ignored warnings to be investigated |work=BBC News |date=22 August 2023 |accessdate=22 August 2023 |archive-date=22 August 2023 |archive-url=https://web.archive.org/web/20230822194459/https://www.bbc.co.uk/news/uk-england-merseyside-66586463 |url-status=live }}</ref> She and other executives at the hospital have been accused of ignoring warnings about Letby.<ref name="BBC 66569258">{{cite news |url=https://www.bbc.co.uk/news/uk-66569258 |title=Alison Kelly: Former nursing manager at Letby hospital suspended |work=BBC News |date=21 August 2023 |accessdate=21 August 2023 |archive-date=21 August 2023 |archive-url=https://web.archive.org/web/20230821190626/https://www.bbc.com/news/uk-66569258 |url-status=live }}</ref>
It was reported that the British government were examining how Letby's pension can be stopped.<ref>{{cite web |title=Child killer Lucy Letby 'to be stripped' of NHS pension after conviction |url=https://www.standard.co.uk/news/politics/killer-lucy-letby-nurse-nhs-pension-steve-barclay-b1102409.html |website=Evening Standard |date=23 August 2023 |access-date=23 August 2023 |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084617/https://www.standard.co.uk/news/politics/killer-lucy-letby-nurse-nhs-pension-steve-barclay-b1102409.html |url-status=live}}</ref> The NHS pension scheme regulations provide for a forfeit of pensions after a conviction of certain crimes.<ref>{{Cite news |date=23 August 2023 |title=Lucy Letby: Killer nurse to be stripped of NHS pension after baby murders |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-nurse-babies-parents-petition-prison-b2397695.html |access-date=23 August 2023 |work=Independent |archive-date=24 August 2023 |archive-url=https://web.archive.org/web/20230824084617/https://www.independent.co.uk/news/uk/crime/lucy-letby-prison-parents-latest-news-b2398457.html |url-status=live}}</ref>
The Government announced that it would introduce new powers to compel convicted criminals to attend sentencing hearings.<ref>{{cite news |title=Criminals to be forced to attend sentencing hearings |work=BBC News |date=30 August 2023 |url=https://www.bbc.co.uk/news/uk-66660136 |access-date=30 August 2023 |archive-date=30 August 2023 |archive-url=https://web.archive.org/web/20230830200235/https://www.bbc.co.uk/news/uk-66660136 |url-status=live}}</ref>
==See also==
* [[List of prisoners with whole life orders]]
* [[List of serial killers in the United Kingdom]]
* [[2011 Stepping Hill Hospital poisoning incident]] – [[Saline (medicine)|saline]] poisoning deaths in [[Greater Manchester]], England
* [[Benjamin Geen]] – British nurse convicted in 2006 of murdering two patients
* [[Genene Jones]] – American nurse responsible for the deaths of up to 60 infants and children in her care during the 1970s and 1980s
* [[Colin Norris]] – British nurse convicted of murdering four patients with insulin in 2008
* [[Harold Shipman]] – British [[general practitioner]] convicted in 2000 of 15 murders but suspected of as many as 250
* [[Elizabeth Wettlaufer]] – Canadian nurse who murdered eight senior patients between 2007 and 2016
==References==
{{Reflist|colwidth=30em|refs=<ref name="Panorama">{{cite AV media
| people = [[BBC One]]
| date = 18 August 2023
| title = Panorama, Lucy Letby: The Nurse Who Killed
| trans-title =
| type = TV documentary
| language =
| url = https://www.bbc.co.uk/programmes/m001q7dl
| access-date = 23 August 2023
| archive-url =
| archive-date =
| time =
| location =
| publisher =
| id =
| isbn =
| oclc =
| quote =
}}</ref>}}
{{Authority control}}
{{DEFAULTSORT:Letby, Lucy}}
[[Category:1990 births]]
[[Category:20th-century British women]]
[[Category:21st-century British women]]
[[Category:21st-century British criminals]]
[[Category:Alumni of the University of Chester]]
[[Category:British female serial killers]]
[[Category:British people convicted of attempted murder]]
[[Category:British women nurses]]
[[Category:English murderers of children]]
[[Category:English nurses]]
[[Category:English prisoners sentenced to life imprisonment]]
[[Category:Criminals from Herefordshire]]
[[Category:Living people]]
[[Category:Nurses convicted of killing patients]]
[[Category:People convicted of murder by England and Wales]]
[[Category:People from Hereford]]
[[Category:Prisoners sentenced to life imprisonment by England and Wales]]' |
Unified diff of changes made by edit (edit_diff) | '@@ -235,5 +235,5 @@
====Doubts about conviction====
-A small number of Letby's friends and former colleagues continued to believe in her innocence.<ref name="Evans 2023">{{Cite news |last=Evans |first=Holly |date=27 August 2023 |title=Friends and colleagues of murderer Lucy Letby insist baby killing nurse is innocent |work=Independent |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |access-date=28 August 2023 |archive-date=28 August 2023 |archive-url=https://web.archive.org/web/20230828215353/https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |url-status=live }}</ref> After the verdict, some analysts highlighted similarities between Letby's trial and the wrongful conviction of [[Lucia de Berk]].<ref name="Steafal 2023">{{cite news |title=How internet sleuths are already trying to prove Lucy Letby innocent |work=The Telegraph |url=https://www.telegraph.co.uk/news/2023/08/24/lucy-letby-appeal-internet-sleuths/ |url-status=live |date=24 August 2023|first1=Eleanor |last1=Steafel |access-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825025512/https://www.telegraph.co.uk/news/2023/08/24/lucy-letby-appeal-internet-sleuths/ |archive-date=25 August 2023}}</ref><ref name="Evans 2023"/>
+A small number of Letby's friends and former colleagues continued to believe in her innocence.<ref name="Evans 2023">{{Cite news |last=Evans |first=Holly |date=27 August 2023 |title=Friends and colleagues of murderer Lucy Letby insist baby killing nurse is innocent |work=Independent |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |access-date=28 August 2023 |archive-date=28 August 2023 |archive-url=https://web.archive.org/web/20230828215353/https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |url-status=live }}</ref>
[[Rachel Aviv]], a staff writer at [[The New Yorker|''The New Yorker'']], published a feature article in May 2024 that questioned Letby's conviction.<ref name="TNY">{{Cite news |last=Aviv |first=Rachel |title=A British Nurse Was Found Guilty of Killing Seven Babies. Did She Do It? |work=The New Yorker |date=13 May 2024 |url=https://www.newyorker.com/magazine/2024/05/20/lucy-letby-was-found-guilty-of-killing-seven-babies-did-she-do-it}}</ref> In the article, Aviv highlighted how pervasive staffing shortages at Countess of Chester Hospital's neonatal unit had led to a dramatic increase in poor care outcomes both during and after Letby's tenure, and noted the consistent use of flawed statistical reasoning by prosecutors. In a case of the [[Texas sharpshooter fallacy]], Aviv claimed that prosecutors placed undue weight on events that supported their theory of the case, while discounting contradictory ones. Aviv also questioned the testimony of Dewi Evans, a retired [[consultant paediatrician]] and prosecution witness whose attestations had "laid the medical foundation for the prosecution’s case" despite a report prepared by Evans as an expert witness in a previous case having been deemed "worthless" as well as expressing opinions that were "tendentious and partisan" and "outside Dr. Evans' professional competence" by a Court of Appeals judge.<ref name="TNY" />
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0 => 'A small number of Letby's friends and former colleagues continued to believe in her innocence.<ref name="Evans 2023">{{Cite news |last=Evans |first=Holly |date=27 August 2023 |title=Friends and colleagues of murderer Lucy Letby insist baby killing nurse is innocent |work=Independent |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |access-date=28 August 2023 |archive-date=28 August 2023 |archive-url=https://web.archive.org/web/20230828215353/https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |url-status=live }}</ref> '
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0 => 'A small number of Letby's friends and former colleagues continued to believe in her innocence.<ref name="Evans 2023">{{Cite news |last=Evans |first=Holly |date=27 August 2023 |title=Friends and colleagues of murderer Lucy Letby insist baby killing nurse is innocent |work=Independent |url=https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |access-date=28 August 2023 |archive-date=28 August 2023 |archive-url=https://web.archive.org/web/20230828215353/https://www.independent.co.uk/news/uk/crime/lucy-letby-killer-nurse-friends-b2400211.html |url-status=live }}</ref> After the verdict, some analysts highlighted similarities between Letby's trial and the wrongful conviction of [[Lucia de Berk]].<ref name="Steafal 2023">{{cite news |title=How internet sleuths are already trying to prove Lucy Letby innocent |work=The Telegraph |url=https://www.telegraph.co.uk/news/2023/08/24/lucy-letby-appeal-internet-sleuths/ |url-status=live |date=24 August 2023|first1=Eleanor |last1=Steafel |access-date=25 August 2023 |archive-url=https://web.archive.org/web/20230825025512/https://www.telegraph.co.uk/news/2023/08/24/lucy-letby-appeal-internet-sleuths/ |archive-date=25 August 2023}}</ref><ref name="Evans 2023"/>'
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283 => 'https://scholar.google.com/scholar?q=%22Lucy+Letby%22',
284 => 'https://www.jstor.org/action/doBasicSearch?Query=%22Lucy+Letby%22&acc=on&wc=on',
285 => 'https://web.archive.org/web/20230904190234/https://www.bbc.com/news/uk-66660136',
286 => 'https://www.bbc.com/news/uk-66660136',
287 => 'https://www.nursingtimes.net/news/children/breaking-lucy-letby-convicted-of-murdering-seven-babies-at-hospital-neonatal-unit-18-08-2023/',
288 => 'https://www.theguardian.com/uk-news/commentisfree/2023/aug/20/lucy-letby-confirms-yet-confounds-our-ideas-of-a-serial-killer',
289 => 'https://www.gov.uk/government/publications/court-of-appeal-cases-fixed-for-hearing-criminal-division/court-of-appeal-cases-fixed-for-hearing-criminal-division',
290 => 'https://www.bbc.com/news/articles/ce965klgv01o',
291 => 'https://www.newyorker.com/magazine/2024/05/20/lucy-letby-was-found-guilty-of-killing-seven-babies-did-she-do-it',
292 => 'https://gill1109.com/2023/10/12/the-timeline-of-the-conspiracy/'
] |
Whether or not the change was made through a Tor exit node (tor_exit_node) | false |
Unix timestamp of change (timestamp) | '1715700814' |